Integrated Body System 3

Lecture 1
 UN SDGs
The Strategy for Teaching and learning is extracted from the Egypt Vision 2030 which is
aligned with the sustainable development goals of the united nations (UN SDGs) 3&4

Universal healthcare system capable of improving health

conditions

A high-quality education and training system

Module specification (the learning
outcomes):

1- Anatomy of Digestive system (GIT) and related Histology

2- Physiology of GIT
3- Pathophysiology of GIT
4- Anatomy of Endocrine system, related Medical terms
5- Physiology of Endocrine system
6- Pathophysiology of Endocrine system
7- Anatomy of female and male reproductive system, related
Histology
8- Physiology of female and male reproductive system,
9- physiology of female and male reproductive system
10- pathophysiology of female and male reproductive system
11- Special Senses
12- Related Medical Terms
Intended Learning Objectives
At the end of the lecture, you should be
able to:
1. Recognize the anatomy of the digestive system.
2. Identify the functions of digestive system.
3. Understand regulation of gastrointestinal tract.
4. Enumerate types of salivary glands and mention
functions of saliva.
5. Recognize regulation of salivary glands
secretion.
The digestive system is formed of:
1. Alimentary canal
2. Digestive glands
Anatomy of the DigestiveSystem
• Digestive tract: also called alimentary tract orcanal
Regions:
➢ Mouth or oral cavity with salivary glands and tonsils.
➢ Pharynx (throat) with tubular mucousglands.
➢ Esophagus with tubular mucousglands.
➢ Stomach with many different kinds of glands that are
tubular.
➢ Small intestine(duodenum, ileum, jejunum) with
liver, gallbladder and pancreasas major accessory
organs.
➢ Large intestine including cecum, colon, rectumand
anal canal with mucous glands.
➢ Anus
• Gastrointestinal system :
1 Alimentary canal

2 Glands :
- Salivary glands
- Gastric glands
- Intestinal glands
- Liver
- pancreas
1. Mucosa
2. Submucosa
3. Circular muscle layer
4. Longitudinal muscle
layer
5. Serosa
Functions of the digestive system
There are six essential
activities:
1. Ingestion.
2. Propulsion.
3. Mechanical Digestion.
4. Chemical Digestion.
5. Absorption.
6. Defecation.
Functions of digestive system

1. Ingestion – taking food into

the digestive tract

2. Propulsion – swallowing and

peristalsis
1. Peristalsis – waves of contraction and
relaxation of muscles in the organ walls.
2. Generated automatically by interstitial cells of
cajal (pacemaker of GIT) and regulated by
nervous and hormonal mechanisms

3. Mechanical digestion –
chewing, and mixing of food
Gastrointestinal Tract
Activities
4. Chemical digestion –
catabolic breakdown of
food by enzymes.

5. Absorption – movement of
nutrients from the GI tract
to the blood or lymph.

6. Defecation – elimination of
indigestible solid wastes.
 Regulation of GITfunctions

Nervous Hormonal

Intrinsic
innervation
Extrinsic
=Enteric
innervation
nervous
system
Intrinsic (enteric) nervous system
 Intrinsic (enteric) nervous system
➢The Gastrointestinal tract has a
nervous system all its own called the
Enteric nervous system (ENS).
➢It lies entirely in the wall of the gut,
beginning in the esophagus and
extending to the anus. Lume
n
Submucosa Myenteric
l plexus plexus
➢The enteric nervous system is
composed mainly of two plexuses:
(1) An outer plexus called the
Myenteric or Auerbach's plexus &
(2) An inner plexus, called the
Submucosal or Meissner's plexus.
The Enteric Nervous System
2 major networks
The two plexuses areinterconnected

myenteric Submucous
(Auerbach’s plexus) (Meissner’ plexus)
Musculosa
(motility) SubMucosa
(secretion)
 The intrinsic (enteric)nervous
system
(1) An outer plexus lying
between the longitudinal
and circular muscle layers,
called the myenteric or
Auerbach's plexus, and
control the MOTILITY
function.
(2) An inner plexus, called
the submucosal or
Meissner's plexus, that
lies in the submucosa and
control the SECRETORY
function.
 Intrinsic Nervous System
Stimuli in the wall of the gut are detected by
Afferent Neurons, which activate
Interneurons and then Efferent Neurons to
alter function.
In this way the ENS can act autonomously
from extrinsic innervation.
 II- The Extrinsic Nervous System
➢ Via the two major subdivisions of the
Autonomic Nervous System
1- Parasympathetic innervation
• The Vagus nerve, innervates the
esophagus, stomach, gallbladder,
pancreas, small intestine, cecum, and
the proximal part of the colon.
• The Pelvic Nerves (S2,3,4) innervate the
distal part of the colon and the anorectal
region.
• These nerves results mainly in
stimulation of GIT motility and secretion.
• The neurotransmitter is acetylcholine.
 Extrinsic nervous system
2- Sympathetic Innervation
• Sympathetic innervation to GIT
arise from T5- L2 segments.
• These nerves results mainly in
inhibition of GIT motility and
secretion.
• Also, it innervates the smooth
muscle cells of blood vessels,
leading to vasoconstriction.
• The neurotransmitter is
norepinephrine.
Regulatory mechanisms in
the GIT
 The Extrinsic Innervation
❖ Dual extrinsic innervation from theautonomic
nervous system:

Parasympathetic Sympathetic (T5-L2)

❑ Vagal , sacral (pelvic). ❑ Greater,lesser
splanchnic.
❑ End on myenteric& ❑ End on the intrinsic
submucous nervous system. (Or
plexuses. directly on muscles and
glands )

❑ Increases motility ❑ Inhibit walls, and

and secretions. secretions contraction to
sphincters.
 Clinical applied physiology
Hirschsprung disease:
❑ The ganglia of the Enteric nervous system (ENS) fail to
develop in the distal bowel, but all other tissue
components are intact and functional.
❑ No propulsive activity occurs in the aganglionic bowel,
and the neonate will die if this region is not removed.
 Inflammatory bowel disease (IBD)
➢ also called Crohn disease orulcerative colitis.
➢ Def :Localized inflammatory degeneration
➢ Site : anywhere along the digestive tract but most commonly
involves the distal ileum andproximal colon.
➢ Pathology :the intestinal wall often becomes thickened,
constricting the lumen, with ulcers andfissures
➢ Symptoms include diarrhea, abdominal pain, fever, fatigue, and
weight loss.
➢ Cause is unknown
➢ Treatments:
• Involve anti-inflammatory drugs.
• Avoidance of foods that producesymptoms.
• Surgery in some cases.
Irritable Bowel Syndrome:(IBS)

Cause : unknown cause.

Symptoms marked by alternating boutsof

constipation and diarrhea.

Risk factors: may be linked to stressor

depression; high familialincidence.
 Hormonal regulation
• The gastrointestinal hormones (or gut hormones)
constitute a group of hormones secreted by
enteroendocrine cells in the stomach, pancreas, and
small intestine that control various functions of the
digestive organs.
• Some of these hormones pass to the portal circulation
to the heart and arterial system to reach the GIT to
affect the smooth muscle activity or gland secretion
(true hormones).
• Others act by a paracrinemanner.
 GIT hormones

1- Gastrin hormone:
Secreted from: G cells in stomach
Function: stimulates gastric acid and pepsinogen
secretion.
2- Somatostatin hormone:
Secreted from: D cells in stomach and pancreas.
Function: inhibits gastric and HCL secretion and
decreases gastrointestinal transit.
 GIT Hormones
3- Cholecystokinin hormone:
Secreted from: I cells in duodenum.
Function: evacuation of bile by gall bladder
contraction and sphincter of Oddi relaxation
(cholagogue) in response to Prescence of fat in
duodenum.
4- Secretin hormone:
Secreted from: S cells in duodenum.
Function: Stimulates secretion of watery alkaline
bile (cholorectic) in response to presence of acid
in duodenum. And increases bicarbonate secretion
from pancreas.
GIT Hormones
Zollinger-Ellison Syndrome:"Pancreatic IsletCell adenoma
Gastrinoma"
➢ non-beta cell tumor in the islets of the pancreas
secrete large amounts of gastrin, resulting in
hypergastrinemia leading to the development of
duodenal ulcers.
Salivary Glands
Three pairs of Extrinsic
glands: Parotid,
Submandibular, and
Sublingual

Intrinsic salivary glands

(buccal glands): scattered
throughout the oral
mucosa
 Acini of salivary gland

Serous cells: secrete

serous (watery) secretion
(ptyalin (a amylase )

Mucous cells: secrete

mucous (viscous) secretion
containing mucin.
 Types of Salivary glands:

• The parotid glands acini are serous.

• The sublingual glands acini are mucous.

• The submandibular glands acini are mixed.

• The buccal glands secrete only mucous.

 Salivary Secretion

25%

70%
5%
 Salivary Glands

Parotid duct
Parotid salivary gland

Sublingual ducts

Lingual frenulum
Opening of
submandibular duct
Sublingual
salivary gland
Submandibular Submandibular
duct salivary gland
Function of the Salivary
Glands

Produce and secrete saliva that:

➢Cleanses the mouth

➢Moistens and dissolves food chemicals
➢Aids in bolus formation and swallowing
➢Contains enzymes that break down
starch
 Protection of
oral mucosa

Digestion Functions Teeth

of Saliva protection

Lubrication and
Wetting
Saliva: Source and
Composition
Secreted from serous and mucous
cells of salivary glands

A 97-99.5% water, hypo-osmotic,

slightly acidic solution containing

Electrolytes: Digestive Proteins : Metabolic

Na+, K+, Cl–, enzyme: mucin, wastes :
PO42–, HCO3– salivary lysozyme, urea and
amylase defensins, uric acid
and IgA
 Composition of Saliva
1500 ml/ day
99.5% 0.5%
Water
Electrolytes: K+,
HCO3-, Na+ and Cl-

proteins: ptyalin and

mucin
pH : 7.0
(slightly
acidic)
 Innervation of salivary glands:
1.Parasympathetic fibers
Parotid gland Submandibular and
sublingual
Preganglionic fibers inferior salivary Superior salivary
arise nucleus in medulla nucleus in medulla

Run as Glossopharyngeal n. Chorda tympani

(facial)
relay Otic ganglion Submandibarl
ganglion
Postganglionic fibers Supply parotid gland Supply Submandibula
and sublingual
gland
 Nervous Regulation of Salivary
Secretion
1-Sympathetic regulation
 Sympathetic stimulation produce:
➢ Viscid secretions
➢ Vasoconstriction of the blood vessels
2- Parasympathetic regulation

❑Parasympathetic stimulation produce:

➢ Increase watery salivary secretion.
N.B: Remember that salivary glands are not supplied by
vagus nerve.
 Mechanism of Salivary Secretion

Conditioned reflexes
Acquired reflexes by learning &
training

Sight, smell, thinking of food

stimulate the salivary nucleus in
brainstem which through
Parasympathetic Efferent stimulate
salivation.
Mechanism of Salivary Secretion
Unconditioned reflexes
➢ Inherent reflexes, don’t need
learning or intact cerebral cortex.
Salivary nucleus
Mechanical
Afferent:
stimulation of buccal 7,9
Parasym-
cavity pathetic
Efferent

Stimulate Taste
Receptors
Afferent via cranial n. Taste
receptor
Salivation

Vii & ix s

Salivary nucleus which

through Parasympathetic
Efferent
Stimulate Salivation
Let’s think together
➢ Submucosal nerve plexus controls the motility
of GIT.
o False.

➢ Salivary glands are supplied by vagus nerve.

o False.

➢ Salivation continues in case of cerebral damage.

o True.