GIT physiology
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Questions and Answers

Which of the following correctly describes the role of intrinsic nerve plexuses in the regulation of digestive function?

  • They act independently of the central nervous system, controlling local reflexes within the digestive tract. (correct)
  • They directly stimulate smooth muscle contraction, bypassing the need for extrinsic autonomic nerves.
  • They are primarily responsible for releasing hormones that regulate digestive function.
  • They facilitate the absorption of nutrients by controlling the permeability of the intestinal epithelium.
  • Which of the following statements accurately describes the relationship between digestion and absorption in the digestive system?

  • Digestion is the process of breaking down large molecules into smaller ones, while absorption involves the transfer of digested materials across the intestinal wall into the bloodstream. (correct)
  • Digestion relies on the absorption of essential enzymes secreted by the pancreas and liver to break down food.
  • Digestion and absorption occur simultaneously, with both processes happening in the same section of the digestive tract.
  • Absorption precedes digestion as nutrients are absorbed from the lumen before being broken down into smaller molecules.
  • The secretion of bile from the liver plays a crucial role in the digestive process. Which of the following statements accurately reflects the function of bile?

  • Bile directly breaks down proteins into amino acids, facilitating their absorption into the bloodstream.
  • Bile emulsifies fats, increasing their surface area for digestion by enzymes. (correct)
  • Bile is a major source of enzymes that digest fats in the small intestine.
  • Bile acts as a catalyst to speed up the breakdown of carbohydrates into simple sugars.
  • The digestive system relies on a complex interplay of factors to regulate its function effectively. Which of the following is NOT a primary mechanism involved in regulating digestive functions?

    <p>The conscious control of skeletal muscle movement in the mouth and esophagus, allowing for voluntary swallowing and chewing. (C)</p> Signup and view all the answers

    Which of the following statements best describes the role of motility in digestive function?

    <p>Motility involves both mixing and moving the contents of the digestive tract, ensuring efficient digestion and absorption. (D)</p> Signup and view all the answers

    Which of the following is NOT a function of HCl in the stomach?

    <p>Stimulation of gastric motility (B)</p> Signup and view all the answers

    What is the main function of retropulsion in the stomach?

    <p>Breaking down food into smaller pieces (C)</p> Signup and view all the answers

    Which of the following is NOT a cause of vomiting?

    <p>Increased gastric motility (A)</p> Signup and view all the answers

    What is the role of the parietal cells in gastric acid secretion?

    <p>Secretion of hydrochloric acid (HCl) (C)</p> Signup and view all the answers

    During which phase of gastric secretion is digestion of proteins initiated?

    <p>Gastric phase (B)</p> Signup and view all the answers

    What is the main mechanism responsible for the movement of H+ ions into the lumen of the stomach?

    <p>H+-K+ ATPase pump (D)</p> Signup and view all the answers

    What is the role of the luminal K+ channel in gastric acid secretion?

    <p>To provide a counterion for Cl- ions (A)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of receptive relaxation?

    <p>Increased gastric motility (B)</p> Signup and view all the answers

    Which of the following statements accurately describes the role of the uvula in swallowing?

    <p>The uvula helps to prevent food from entering the nasal passages. (A)</p> Signup and view all the answers

    What is the primary function of the pyloric sphincter?

    <p>To regulate the flow of chyme from the stomach into the duodenum. (C)</p> Signup and view all the answers

    Which of the following is NOT a function of saliva?

    <p>Promoting the absorption of water in the small intestine. (D)</p> Signup and view all the answers

    Which of these statements correctly describes the mechanical action of mastication?

    <p>Mastication is a process of voluntary muscle contractions that facilitate swallowing. (C)</p> Signup and view all the answers

    Which of the following digestive actions is primarily associated with the stomach?

    <p>Mechanical mixing and churning of food. (D)</p> Signup and view all the answers

    Which of the following statements accurately describes the relationship between the esophagus and the stomach?

    <p>The esophagus and stomach are both lined with smooth muscle that aids in peristalsis. (A)</p> Signup and view all the answers

    Which of the following statements best describes the role of the epiglottis during swallowing?

    <p>The epiglottis prevents food from entering the trachea and the lungs. (C)</p> Signup and view all the answers

    Which of the following is NOT considered to be a function of the digestive system?

    <p>Production of hormones that regulate blood glucose levels. (B)</p> Signup and view all the answers

    Which of the following statements accurately describes the role of gastrin in the gastric phase of digestion?

    <p>Gastrin plays a significant role in both increasing gastric motility and stimulating the secretion of HCl and pepsinogen. (D)</p> Signup and view all the answers

    In the intestinal phase of digestion, what is the primary mechanism by which the duodenum controls the rate of gastric emptying?

    <p>Through the enterogastric reflex, the duodenum sends signals to the stomach, triggering the release of inhibitory hormones that slow down gastric emptying. (D)</p> Signup and view all the answers

    Which of the following hormone(s) directly contribute to the reduction of gastric motility and secretion during the intestinal phase of digestion?

    <p>Both Secretin and Cholecystokinin (CCK). (A)</p> Signup and view all the answers

    What is the primary trigger for the release of secretin and CCK during the intestinal phase of digestion?

    <p>The presence of chyme in the duodenum. (A)</p> Signup and view all the answers

    The cephalic phase of digestion is characterized by:

    <p>The stimulation of gastric juice production and release of gastrin, primarily driven by neural signals from the CNS. (A)</p> Signup and view all the answers

    Which of the following is NOT a function of the liver?

    <p>Production of gastric juice. (C)</p> Signup and view all the answers

    What is the primary mechanism by which the enterogastric reflex slows down gastric emptying?

    <p>Through the enterogastric reflex, the duodenum sends signals to the stomach, triggering the release of inhibitory hormones that slow down gastric emptying. (A)</p> Signup and view all the answers

    Which of the following best describes the role of bile salts in digestion?

    <p>Bile salts primarily contribute to the emulsification of fats, increasing their surface area for enzymatic digestion. (D)</p> Signup and view all the answers

    Which of the following statements is FALSE regarding the absorption of vitamins?

    <p>The absorption of all vitamins is dependent on adequate levels of active vitamin D, which is essential for facilitating their uptake into the intestinal epithelial cells. (D)</p> Signup and view all the answers

    Which of the following is NOT a factor that directly contributes to the movement of water into the lumen of the duodenum?

    <p>The secretion of digestive enzymes from the pancreas, which increases the osmotic pressure of the duodenal contents. (B)</p> Signup and view all the answers

    What is the role of bile in lipid absorption in the small intestine?

    <p>Bile emulsifies lipids, increasing their surface area and facilitating the action of pancreatic lipase for digestion. (D)</p> Signup and view all the answers

    Which of the following statements accurately describes the absorption of iron in the small intestine?

    <p>The absorption of iron is a tightly regulated process, with less than 10% of ingested iron being absorbed, and women generally absorb more than men. (D)</p> Signup and view all the answers

    What is the primary mechanism by which the small intestine maintains biochemical balance between the stomach, pancreas, and itself?

    <p>By tightly regulating the secretion and absorption of acid and base, ensuring a neutral pH balance. (C)</p> Signup and view all the answers

    What is the primary function of bile salts in fat digestion?

    <p>To emulsify large fat globules into smaller droplets. (A)</p> Signup and view all the answers

    Which of the following statements about the enterohepatic circulation is TRUE?

    <p>It involves the recycling of bile salts between the small intestine and the liver. (B)</p> Signup and view all the answers

    What is the role of CCK in digestion?

    <p>Promotes gallbladder contraction and relaxation of the hepatopancreatic sphincter. (C)</p> Signup and view all the answers

    Which of the following pancreatic enzymes is secreted in an active form?

    <p>Pancreatic Amylase (B)</p> Signup and view all the answers

    What is the primary function of the pancreatic bicarbonate solution?

    <p>Neutralize acidic chyme from the stomach. (B)</p> Signup and view all the answers

    Which of the following hormones stimulates the release of pancreatic enzymes?

    <p>CCK (A)</p> Signup and view all the answers

    Which of the following is NOT a primary function of the liver?

    <p>Secretion of insulin and glucagon. (D)</p> Signup and view all the answers

    Which of the following statements about the liver’s blood flow is TRUE?

    <p>The liver receives blood from both the hepatic artery and the hepatic portal vein. (C)</p> Signup and view all the answers

    Which of the following is a major hormone of the duodenum?

    <p>All of the above (D)</p> Signup and view all the answers

    Which of the following statements about bile is TRUE?

    <p>Bile is diverted to the gallbladder between meals. (C)</p> Signup and view all the answers

    Which of the following is NOT a function of the pancreas?

    <p>Production of bile. (B)</p> Signup and view all the answers

    Which of the following statements about pancreatic insufficiency is CORRECT?

    <p>It is characterized by a deficiency of pancreatic enzymes. (B)</p> Signup and view all the answers

    Which of the following digestive hormones is NOT primarily produced by the duodenum?

    <p>Gastrin (C)</p> Signup and view all the answers

    Which of the following is the primary function of the enzyme carboxypeptidase?

    <p>Breakdown of proteins from the carboxyl end. (C)</p> Signup and view all the answers

    Flashcards

    Digestive Processes

    Four basic processes: motility, secretion, digestion, absorption.

    Motility

    Contraction of smooth muscle for mixing and moving contents in GIT.

    Secretion

    Release of substances like mucus, enzymes, and hormones during digestion.

    Digestion

    Chemical breakdown of large food molecules into smaller absorbable units.

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    Absorption

    Transfer of digested nutrients from GIT into blood or lymph.

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    GI hormones

    Hormones released by the gastrointestinal tract that regulate digestion.

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    Receptors in digestive tract

    Chemoreceptors, mechanoreceptors, and osmoreceptors that detect stimuli related to digestion.

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    Oral cavity functions

    Main roles include mastication, swallowing initiation, salivation, and taste perception.

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    Mastication

    Mechanical breakdown of food by teeth through slicing and grinding.

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    Composition of saliva

    Saliva consists of 99.5% water and 0.5% electrolytes, proteins, and mucus.

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    Functions of saliva

    Includes initiating digestion, antibacterial action, dissolving molecules, and aiding swallowing.

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    Pharynx and esophagus

    Pharynx is a common passageway; esophagus moves food to the stomach via peristalsis.

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    Swallowing process

    Involves voluntary and reflex actions for moving food from the mouth to the stomach.

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    Receptive Relaxation

    Expansion of stomach cavity with minimal increase in pressure.

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    Retropulsion

    Churning action in the pyloric antrium that breaks food into chyme.

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    Gastric Emptying

    Controlled propulsion of chyme into the duodenum during peristalsis.

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    Vomiting Mechanism

    Involves contraction of muscles while stomach and esophagus relax.

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    Hydrochloric Acid (HCl)

    Secreted by parietal cells to activate pepsinogen and aid digestion.

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    Functions of HCl

    Denatures proteins, kills microorganisms, and activates pepsin.

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    Cephalic Phase

    Initial phase preparing the stomach for food arrival.

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    Gastric Phase

    Increased secretion that starts digestion of proteins in the stomach.

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    Intestinal Phase

    Phase of digestion controlling gastric emptying and hormone release.

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    Gastrin

    Hormone increasing production of HCl and gastric motility.

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    CCK (Cholecystokinin)

    Hormone that decreases gastric motility and secretion.

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    Enterogastric Reflex

    Reflex triggered by duodenum distension affecting gastric contraction.

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    Functions of the Liver

    Roles include bile secretion, nutrient processing, and detoxifying.

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    Sodium channels

    Transmembrane proteins that facilitate the passage of sodium ions (Na+) across the cell membrane.

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    Na+ - Cl- symporter

    A co-transport carrier that simultaneously transports sodium ions (Na+) and chloride ions (Cl-) into cells.

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    Passive absorption of water

    The movement of water is driven by osmotic gradients without the need for energy.

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    Vitamin B12 absorption

    Vitamin B12 is absorbed through receptor-mediated endocytosis, requiring a complex with intrinsic factor.

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    Iron absorption

    Iron is absorbed in varying amounts based on its form, with heme iron being more efficiently absorbed than Fe2+ and Fe3+.

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    Calcium absorption mechanism

    Calcium absorption in the intestines requires the activation of Vitamin D.

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    Impact of diarrhea

    Diarrhea leads to loss of fluids and electrolytes, often causing dehydration and metabolic acidosis.

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    Role of small intestine

    Most nutrients absorbed in the small intestine are processed through the liver, except for lipids which enter the lymphatic system.

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    Liver Blood Flow

    The liver receives blood from the hepatic artery and hepatic portal vein for processing.

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    Hepatic Portal Vein

    Vein that carries venous blood from the digestive tract to the liver.

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    Bile

    A substance secreted by the liver, aiding in fat digestion and containing salts, cholesterol, and bilirubin.

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    Gallbladder

    Organ that stores and concentrates bile between meals.

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    Bile Salts

    Derivatives of cholesterol that aid in fat digestion and are recycled in enterohepatic circulation.

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    Enterohepatic Circulation

    The recycling process of bile salts between the liver and the intestine.

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    Fat Emulsion

    Bile salts convert large fat globules into smaller droplets for absorption.

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    Micelles

    Aggregates of bile salts and fats that aid in fat digestion and absorption.

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    Excretion of Bilirubin

    Bilirubin, a waste product, is excreted via bile and has no role in digestion.

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    Pancreas

    A gland with both exocrine and endocrine functions, located behind the stomach.

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    Pancreatic Amylase

    Enzyme that breaks down complex carbohydrates into simpler sugars.

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    Pancreatic Lipase

    Main enzyme responsible for fat digestion in the gastrointestinal tract.

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    Proteolytic Enzymes

    Pancreatic enzymes (like trypsin) that break down proteins; secreted in inactive forms.

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    Study Notes

    HSC1008 Anatomy and Physiology 2

    • Course name: HSC1008 Anatomy and Physiology 2
    • Course topic: Digestive System
    • Lecturer: Andy Lee (PhD), Assistant Professor
    • Contact details: Faculty Hall #04-17, 6592 2524, [email protected]

    Digestive System 1

    • Learning Outcomes:
      • Describe the 4 basic digestive processes
      • Discuss the main functions of the oral cavity and the mechanisms involved
      • Discuss the main functions of the stomach, liver and pancreas
      • Explain the control of gastric secretion and motility
      • Discuss the mechanism and control of bile and pancreatic secretions
      • Describe the role of the main GI hormones in regulation of digestive function

    Revision (Anatomy)

    • Diagram including: Nasal passages, mouth, salivary glands, pharynx, pharyngoesophageal sphincter, trachea, esophagus, gastroesophageal sphincter, liver, stomach, gallbladder, gallbladder, pancreas, duodenum, descending colon, transverse colon, ascending colon, jejunum, cecum, ileum, appendix, sigmoid colon, rectum, and anus.

    A Journey Through the Digestive System

    4 Basic Digestive Processes

    • Motility:
      • Contraction of smooth muscle in the digestive tract
      • Mixing and moving the contents in the GIT
    • Secretion:
      • Exocrine and endocrine secretions
      • Mucus along entire digestive tract
      • Saliva, acid, enzymes, bile, bicarbonate, hormones, etc
    • Digestion:
      • Food molecules are generally large
      • Cannot cross the plasma membrane of intestinal epithelial cells
      • Chemically break down complex macromolecules into smaller absorbable molecules.
    • Absorption:
      • Digested material transferred from GIT lumen to blood or lymph

    Oral Cavity and Esophagus

    • Swallowing - All-or-none reflex
      • Oropharyngeal stage
        • Tongue pushes bolus of food to the pharynx
        • Note functions of uvula, tongue, glottis, and epiglottis
      • Esophageal stage
        • Peristaltic wave from beginning to end of esophagus
        • Forcing bolus toward the stomach

    Swallowing

    • Video on Swallowing:

    Stomach

    • J-shaped chamber
      • Stores food
      • Begins protein digestion
      • Mixing movements produce chyme

    Gastric Storage, Mixing and Emptying

    • Storage:
      • Body of stomach
      • Receptive relaxation - expansion with little change in intragastric pressure
    • Mixing:
      • Mainly in the pyloric antrum
      • Peristaltic contractions are stronger and more vigorous
      • Retropulsion - churning action breaks food into smaller pieces forming chyme.
    • Emptying:
      • Controlled propulsion of chyme into the duodenum with each peristaltic wave

    Gastric Emptying and Mixing

    • Diagram showing peristaltic contraction, gastric emptying, and mixing with labels for esophagus, stomach, gastroesophageal sphincter, pyloric sphincter, duodenum

    Digestion in Stomach

    • Labels for esophagus, gastroesophageal sphincter, pyloric sphincter, duodenum, and smooth muscle

    Gastric Motility and Emptying

    • Factors regulating gastric motility and emptying:
      • Within the stomach
        • Volume of chyme - distension affects gastric smooth muscle excitability
        • Degree of fluidity - contents need to be fluid
      • Within the duodenum
        • Presence of fat, acid, hypertonicity, or distension - triggers enterogastric reflex
      • Outside the digestive system
        • Emotion - alters autonomic balance
        • Intense pain - increases sympathetic activity
    • Table includes effects on gastric motility and emptying

    Vomiting

    • Not a function of retroperistalsis in the stomach
    • Contraction of respiratory muscles and abdominal muscles
    • Stomach, esophagus, and sphincters relaxed.
    • Controlled by vomiting center (area postrema - medulla of brainstem)
    • Causes: Throat stimulation, irritation of stomach, elevated intracranial pressure, etc.

    Gastric Secretion

    • Diagram including surface epithelial cells, gastric pits, gastric glands, pyloric atrium, mucous cells, chief cells, parietal cells, enteroendocrine/paracrine cells, ECL cells, G cells, D cells

    Gastric Acid Secretion

    • Hydrochloric acid secreted by parietal cells and activates pepsinogen
    • Mechanism of H+ and Cl- secretion:
      • CO2 + H2O → HCO3− + H+
      • H+-K+ ATPase pump
      • Luminal K+ channel allows K+ to passively leak back
      • Cl− - HCO3− antiporter
      • Cl− channel

    Functions of HCl

    • Formation of pepsin
    • Breakdown of connective tissue and muscle fibers
    • Denaturation of protein
    • Killing of microorganisms

    Control of Gastric Secretion

    • Cephalic Phase: prepares stomach for arrival of food
    • Gastric Phase: increased secretion started in the previous phase, initiates digestion of proteins
    • Intestinal Phase: controls rate of gastric emptying

    Cephalic Phase

    • Preparing stomach for arrival of food
    • Short phase (minutes)
    • Directed by CNS via vagus nerve and submucosal plexus
    • Increased production of gastric juice and release of gastrin

    Gastric Phase

    • Increased secretion of gastric juice
    • Long phase (3-4 hours)
    • Stimulation of stretch and chemoreceptors
    • Effects of gastrin (release of histamine and its local effect)
    • Sustained increased production of gastric juice and increased motility (mixing)

    Intestinal Phase

    • Control of rate of gastric emptying
    • Long duration
    • Distension of duodenum triggers enterogastric reflex
    • Stimulation of CCK, GIP, and secretin release (hormone release)
    • Feedback inhibition of pepsinogen and HCl production and gastric motility

    General Effect of Some GI Hormones on Gastric Function

    • Gastrin: ↑ HCl, pepsinogen, gastric motility
    • Secretin, GIP, and CCK: ↓ gastric motility and secretion

    Intestinal Phase

    • Distension of duodenum triggers enterogastric reflex - ↓ gastric contraction
    • Arrival of chyme in duodenum (lipids, carbohydrates, low pH) trigger release of hormones (secretin, CCK, etc.) - ↓gastric contraction, ↓gastric secretions

    Functions of the Liver

    • Secretion of bile salts
    • Metabolic processing of nutrients
    • Detoxifying/degrading
    • Synthesizing plasma proteins
    • Storing glycogen, fats, vitamins, etc.
    • Activating vitamin D
    • Hormone secretion
    • Excretion of cholesterol and bilirubin
    • Removing bacteria and worn-out RBCs

    Liver Blood Flow

    • The liver receives blood from two sources:
      • Arterial blood (O2 supply and blood-borne metabolites) delivered by the hepatic artery.
      • Venous blood (draining the digestive tract) carried by the hepatic portal vein for processing and storage of newly absorbed nutrients
    • Blood leaves the liver via the hepatic vein.

    Bile

    • Continuously secreted by the liver into the duodenum and diverted to the gallbladder between meals
    • Contains bile salts, cholesterol, lecithin, bilirubin, etc. (without digestive enzymes)
    • Bile concentrated in the gallbladder

    Enterohepatic Circulation

    • Bile salts are recycled through the enterohepatic circulation.
    • Bile salts are derivatives of cholesterol
    • Enterohepatic circulation: recycling of bile salts between the small intestine and liver.

    Functions of Bile

    • Aid fat digestion and absorption
    • Detergent action of bile salts converting large fat globules into small fat droplets
    • Formation of micelles
    • Bile salts and lecithin aggregate in small clusters.
    • Fat-soluble parts huddle together in the middle to form a hydrophobic core.

    Functions of Bile

    • Excretion of water-insoluble substances (e.g., cholesterol and bilirubin) - bilirubin has no role in digestion
    • Bile salts stimulate bile secretion
    • CCK promotes gallbladder emptying (contraction of gallbladder) and relaxation of the sphincter of Oddi/hepatopancreatic sphincter (HPS)
    • Hepatitis and cirrhosis are common liver disorders

    Pancreas

    • The pancreas is a mixture of exocrine and endocrine tissue
    • An elongated gland behind and below the stomach
    • Exocrine function
      • Pancreatic enzymes by the acinar cells (e.g., pancreatic amylase, lipase, pancreatic proteolytic enzymes)
      • Aqueous alkaline solution (e.g., bicarbonate)

    Pancreatic Enzymes

    • Pancreatic Amylase (active form, breaks down starch and glycogen)
    • Pancreatic Lipase (fat digestion, triglycerides into monoglycerides and free fatty acids)
    • Pancreatic Proteolytic Enzymes (Proteases, inactive form - trypsinogen, chymotrypsinogen, and procarboxypeptidase, activated by enteropeptidase, trypsin activates other enzymes and is also autocatalytic)

    Pancreas

    • Aqueous alkaline solution
    • Pancreatic enzymes are optimal in neutral or slightly alkaline environments
    • Neutralizes acidic chyme
    • High concentration of bicarbonate (HCO3−)
    • Pancreatic insufficiency: deficient pancreatic enzymes, impairing dietary fat digestion

    Hormonal Control of Pancreatic Secretion

    • Secretion of aqueous NaHCO3 solution into duodenal lumen
    • Hormonal control of pancreatic digestive enzyme secretion

    Overview of the GI Hormones

    • Gastrin: Stimulated by protein in stomach, ↑ secretion of HCl and pepsinogen, enhances gastric motility
    • Secretin: Stimulated by acid in duodenum, inhibits gastric emptying and gastric secretion, stimulates pancreas to produce HCO3
    • CCK: Stimulated by chyme in duodenum; inhibits gastric motility and secretion; stimulates pancreatic enzyme secretion; stimulates contraction of gallbladder and relaxation of hepatopancreatic sphincter
    • GIP: Promotes metabolic processing of nutrients once they are absorbed

    Major Hormones of the Duodenum

    • Gastrin (secreted by G cells, ↑ stomach motility, ↑ acid/enzyme production)
    • Secretin (↑ bile secretion, ↑ pancreatic buffer secretion, ↓ gastric motility)
    • GIP (↑ insulin secretion, ↓ gastric emptying,↑ glucose usage by skeletal muscles)
    • Cholecystokinin (CCK) (↑ pancreatic enzyme secretion, relaxation of sphincter of Oddi, contraction of gallbladder)
    • VIP (stimulates intestinal glands; dilates regional capillaries; inhibits acid production)
    • Enterocrinin (stimulates mucin production by submucosal glands)

    Function of Major Digestive Tract Hormones

    • Diagram showing hormones their actions, and digestive tract sections (eg. Stomach, Pancreas, Small intestine)

    Small Intestine

    • 3 parts: duodenum, jejunum, and ileum
    • Site of most digestion and absorption
    • Approximately 5-6 meters long
    • Motility
      • Peristalsis: waves of muscular contractions that move the bolus through the digestive tract.
      • Segmentation contractions: mixing and slow propulsion of the chyme
    • Myenteric plexus - essential for these movements.

    Peristalsis

    • Waves of muscular contractions
    • Moves bolus along digestive tract, oral-to-anal direction
    • Myenteric plexus is essential

    Segmentation Contraction

    • Mixes and slowly propels chyme
    • Oscillating, ring-like contractions every few centimeters
    • Functions: mixing chyme with digestive juices, exposing chyme to all absorptive surfaces

    Myenteric Plexus

    • Located between longitudinal and circular muscle layers
    • Controls mainly gastrointestinal movements, stimulated by receptors in digestive tract

    Small Intestine - Motility

    • Migrating motility complex (MMC): sweeps intestine clean between meals.
    • Ileocecal juncture
      • Prevents contamination of the small intestine by colonic bacteria.
      • Ileocecal valve and sphincter.

    Small Intestine - Secretion

    • Pancreatic enzymes perform most digestive activities.
    • Enzymes secreted by enterocytes (localized at the brush border)
      • Enteropeptidase
      • Disaccharidases (maltase, lactase, sucrose-isomaltase, lactase)
      • Aminopeptidases

    Carbohydrates

    • Monosaccharides: fructose, glucose, galactose
    • Disaccharides: sucrose, maltose, lactose
    • Polysaccharides: starch, glycogen, etc

    Proteins

    • Amino acids
    • Peptides
    • Polypeptides
    • Protein (chains of >50 amino acids).

    Summary for 3 Major Classes of Nutrients

    • Table summarizing digestive processes for carbohydrates, proteins, and fats

    Adaptation for Absorption

    • Diagram showing circular folds, villi, and microvilli in the small intestine, increasing surface area for absorption.

    Mechanisms of Absorption

    • Diffusion (simple and facilitated)

      • Monoglycerides and fatty acids etc
      • Fructose, amino acids, etc
    • Active Transport (primary and secondary)

      • Sodium
      • Glucose, amino acids, and peptides, etc

    Digestion and Absorption in Small Intestine

    • Digestion: description of digestion and movement of ingredients through to intestines

    Carbohydrate Digestion and Absorption

    • Mainly starch and glycogen
    • Enzymes: salivary amylase, pancreatic amylase, and disaccharidases convert carbohydrates (starch/glycogen) to monosaccharides like glucose, fructose, and galactose
    • Cellulose is plant cell wall, not digestible by humans
    • Major end-product is glucose.

    Carbohydrate Digestion

    • Dietary carbohydrates are broken down into monosaccharides, and these are absorbed by the epithelial cells of the small intestine

    Carbohydrate Absorption

    • Monosaccharides (glucose, galactose,or fructose) absorbed into the epithelial cells by active transport (Na+) using a symporter (SGLT).
    • Fructose absorption is via facilitated diffusion (GLUT5)
    • Passive facilitated diffusion through GLUT2 into the blood

    Protein Digestion and Absorption

    • Digestion begins in the stomach (pepsinogen ---> pepsin --> protein ---> polypeptides)
    • Continues in the small intestine (trypsin, chymotrypsin - to peptides ---> amino acids, aminopeptidases)

    Protein Absorption

    • Amino acids absorbed via Na+/amino acid symporters
    • Small peptides absorbed via H+/peptide secondary active transport

    Fat Digestion

    • Dietary fats (triglycerides) emulsified by bile salts into small droplets.
    • Pancreatic lipase hydrolyzes triglycerides into monoglycerides and free fatty acids
    • Monoglycerides and free fatty acids are absorbed into water-soluble micelles via passive diffusion
      • Bile salts
      • forming water-soluble micelle

    Fat Absorption

    • Digested fat (monoglycerides, free fatty acids) passively enter the lymph via micelles, chylomicrons form in epithelial cells and then aggregate and are coated with lipoproteins.
    • Chylomicrons then extruded from cells via exocytosis and enter the lymph system.

    Absorption of Sodium Chloride

    • Na+-K+ ATPase creates electrochemical gradient
    • Co-transport carriers (Na+-Cl− symporter, Na+-H+ antiporter, Na+-glucose symporter, Na+-amino acid symporter)

    Absorption of Water

    • Active reabsorption of electrolytes and nutrients creates osmotic gradients.
    • Na+ - K+ ATPase creates localized concentrated area of high osmotic pressure.
    • Water flows into the lumen due to hyperosmotic chyme in the duodenum.
    • Water is absorbed in the jejunum and ileum.

    Absorption of Vitamins

    • Water-soluble vitamins (e.g., vitamin B complex, vitamin C) - mostly by carrier-mediated mechanisms
    • Fat-soluble vitamins (e.g., vitamin A, D, E, K) - carried in micelles and absorbed with other lipids
    • Vitamin B12 - absorbed by receptor-mediated endocytosis. Requires a complex binding with gastric intrinsic factor

    Absorption of Iron and Calcium

    • Iron absorption regulated, needed for hemoglobin production.
    • Heme iron > Fe2+ (ferrous) > Fe3+ (ferric iron)
    • Vitamin C ↑iron absorption by reducing Fe3+ to Fe2+.
    • Calcium absorption - activation of vitamin D in kidney or liver is required for effective calcium absorption.
    • 2/3 of daily calcium intake is absorbed

    Small Intestine - Maintaining Biochemical Balance

    • Biochemical balance among stomach, pancreas, and small intestine is maintained.
    • Body normally does not experience a net gain or loss of acid or base during digestion
    • Diarrhea results in fluid and electrolyte loss from highly fluid fecal matter.
      • Excessive small intestinal motility
      • Excess osmotically active particles in the lumen
      • Toxins
    • Dehydration, loss of nutrients, and metabolic acidosis, etc

    Large Intestine

    • The large intestine is primarily a drying and storage organ.
      • Forms and stores feces
    • Motility
      • Slow and non-propulsive.
      • Contractions of haustra slowly shuffle colonic contents back and forth and are initiated by rhythmic smooth muscle contractions.
      • Mass movements propel feces long distances into the distal part
        • Large segments of the ascending and transverse colon that contract simultaneously.

    Defecation Reflex

    • Feces are eliminated by the defecation reflex.
    • Initiated by distension of the rectum
    • Stimulates stretch receptors in the rectal wall
    • Muscle contraction with relaxation of both the internal and external anal sphincter muscle.
    • Voluntary straining movements increase intra-abdominal pressure,
    • Contraction of abdominal muscles, and
    • Forcible expiration against closed glottis (reflex)

    Defecation Reflex

    • 2 positive feedback loops
      • Short intrinsic myenteric defecation reflex.
        • Stretch receptors stimulate the plexus to increase local peristaltic contractions in the sigmoid colon and rectum.
    • Parasympathetic defecation reflex.
      • Stimulate mass movements in descending and sigmoid colon.

    Constipation

    • When feces become too dry
    • Abdominal discomfort, dull headache, loss of appetite, etc
    • Causes:
      • Ignoring urge to defecate
      • Decreased colonic motility
      • Obstruction
      • Impairment of defecation reflex

    Gases and Secretions

    • Intestinal gases are absorbed or expelled (flatus)
    • Bacterial fermentation produces gases
    • Large-intestine secretion is entirely protective (mucus solution)
    • Colon contains myriad beneficial bacteria (microbiota and microbiome)

    Absorption of Water and Salt

    • The large intestine absorbs salt and water
    • Converting luminal contents to feces
    • Some absorption takes place within the colon but not to the same extent as in the small intestine
      • Na+ actively absorbed
      • Cl− follows down electrical gradient
      • Water follows osmotically

    References

    • Chapter 16, Sherwood, L. (2016) Human Physiology: From Cells to Systems. 9th edition. Cengage
    • Chapter 24, Martini, F. H., Nath, J.L., & Bartholomew, E. F. (2018). Fundamentals of Anatomy and Physiology. 11th Global Edition. Pearson.

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    Test your knowledge on the intricate roles of various components in the digestive system. This quiz covers intrinsic nerve plexuses, bile secretion, gastric motility, and many other key functions that regulate digestion and absorption. Challenge yourself to identify accurate statements about digestive processes and mechanisms.

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