DIGESTIVE

SYSTEM
UNIT II

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 CONTENTS
•Anatomy of GI Tract
•Anatomy and functions of stomach
•Acid production in the stomach
•Regulation of acid production through parasympathetic
nervous system
•Pepsin role in protein digestion
•Anatomy and functions of small intestine and large intestine
•Anatomy and functions of salivary glands, pancreas and liver,
•Movements of GIT
•Digestion and absorption of nutrients
•Disorders of GIT.
• Digestion is defined as the process by which food is broken
down into simple chemical substances that can be absorbed
and used as nutrients by the body.
• Digestive tract is also called as alimentary tract.
• It provides continual supply of water, electrolytes, and nutrients.
• To achieve this requires
• (1) movement of food through the alimentary tract;
• (2) secretion of digestive juices and digestion of the food;
• (3) absorption of water, various electrolytes, and digestive products;
• (4) circulation of blood through the gastrointestinal organs to carry
away the absorbed substances; and
• (5) control of all these functions by local, nervous, and hormonal
systems.
 INTRODUCTION
• Digestion
is defined as the process by which food is broken
down into simple chemical substances that can be
absorbed and used as nutrients by the body.
• Digestive
process is accomplished by mechanical and
enzymatic breakdown of food into simpler chemical
compounds.
•A normal young healthy adult consumes about 1 kg of solid
diet and about 1 to 2 liter of liquid diet every day.

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• The functions of digestive system include:
• 1.Ingestion or consumption of food substances, breaking
them into small particles
• 2.Transport of small particles to different areas of the
digestive tract
• 3. Secretion of necessary enzymes and other substances
for digestion
• 4. Digestion of the food particles
• 5. Absorption of the digestive products (nutrients)
• 6. Defecation or Removal of unwanted substances from
the body.
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 Anatomy of digestive system
•Digestive system is made up of gastrointestinal tract (GI
tract) or alimentary canal and accessory organs, which
help in the process of digestion and absorption.
•GI tract is a tubular structure extending from the mouth up
to anus, with a length of about 30 feet.
•GI tract is formed by two types of organs:
•1. Primary digestive organs.
•2. Accessory digestive organs.

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 Nervous system controlling digestive system
•The nervous system of gastrointestinal tract is called the
enteric nervous system.
•Itlies entirely in the wall of the gut, beginning in the
esophagus and extending all the way to the anus.
•The number of neurons in this enteric system is about 100
million.
•Enteric nervous system is especially important in
controlling gastrointestinal movements and secretion.

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 Primary Digestive Organs
•Primary digestive organs are the organs where actual digestion takes place.
•Primary digestive organs are:
•i. Mouth

•ii. Pharynx

•iii. Esophagus
•iv. Stomach

•v. Small intestine

•vi. Large intestine.

•Vii. Anus
•Viii. Rectum

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 Accessory Digestive Organs
•Accessory digestive organs are those which help the primary digestive
organs in the process of digestion.
•Accessory digestive organs are:
•i. Teeth
•ii. Tongue
•iii. Salivary glands
•iv. Exocrine part of pancreas
•v. Liver
•vi. Gallbladder.

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 Wall of Gastrointestinal Tract
• Wall of the GI tract is formed by four layers which are from
inside out:
• 1. Mucus layer (mucosa)
• (1) a layer of epithelium in direct contact with the contents of the GI tract,
• (2) a layer of connective tissue called the lamina propria, and
• (3) a thin layer of smooth muscle (muscularis mucosae).
• 2. Submucus layer
• 3. Muscular layer
• 4. Serous or fibrous layer.
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 MOUTH
• Mouth is otherwise known as oral cavity or
buccal cavity.
• It is formed by cheeks, lips, palate, teeth, tongue
and salivary glands.
• Digestive juice present in the mouth is saliva,
which is secreted by the salivary glands.

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Parotid glands, Sub-maxillary , Sublingual glands
 FUNCTIONS OF MOUTH
• Ingestion of food materials
• Chewing the food and mixing it with saliva
• Appreciation of taste of the food
• Transfer of food (bolus) to the esophagus by
swallowing
• Role in speech
• Social functions such as smiling and other
expressions.

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 Superior lip
Superior labial frenulum

Gingivae (gums)
Hard palate
Palatoglossal arch
Soft palate
Fauces

Tongue (lifted upward)

Uvula Lingual frenulum

Inferior labial frenulum

Inferior lip (pulled down)

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 SALIVARY GLANDS
• Gland that secretes saliva into oral cavity.
• Saliva is secreted by three pairs of major (larger)
salivary glands and some minor (small) salivary
glands.
• Major glands are:
• 1. Parotid glands
• 2. Submaxillary or submandibular glands
• 3. Sublingual glands.
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 Parotid Glands
• Largest of all salivary glands.
• situated at the side of the face just below and in
front of the ear.
• Each gland weighs about 20-30 g in adults.
• Secretions from these glands are emptied into the
oral cavity by Stensen duct.
• This duct is about 35-40 mm long and opens inside
the cheek against the upper second molar tooth

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 Submaxillary Glands
• located in submaxillary triangle, medial to mandible.
• Each gland weighs about 8-10 g. Saliva from these
glands is emptied into the oral cavity by Wharton
duct, which is about 40 mm long.
• The duct opens at the side of frenulum of tongue,
by means of a small opening on the summit of
papilla called caruncula sublingualis.

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 Sublingual Glands
• Smallest salivary glands situated in the mucosa at the floor of
the mouth
• Each gland weighs about 2-3 g.
• Saliva
from these glands is poured into 5-15 small ducts called
ducts of Rivinus.
• These ducts open on small papillae beneath the tongue.
• One of the ducts is larger and it is called Bartholin duct.
• It
drains the anterior part of the gland and opens on
caruncula sublingualis near the opening of submaxillary duct.
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 MINOR SALIVARY GLANDS
• 1. Lingual Mucus Glands
• Situated in
posterior one third of the tongue, behind
circumvallate papillae and at the tip and margins of tongue.
• 2. Lingual Serous Glands
• Located near circumvallate papillae and filiform papillae.
• 3. Buccal Glands
• Present between the mucus membrane and buccinator muscle.
• 4-5 of
these are larger and situated outside buccinator, around the
terminal part of parotid duct.

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•4. Labial Glands
•Labial glands are situated beneath the
mucus membrane around the orifice
of mouth.
•5. Palatal Glands
•Palatal glands are found beneath the
mucus membrane of the soft palate.

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 CLASSIFICATION OF SALIVARY GLANDS
• Salivary glands are classified into three types, based on the type of secretion:
• 1. Serous Glands
• Serous glands are mainly made up of serous cells. These glands secrete thin and
watery saliva. Parotid glands and lingual serous glands are the serous glands.
• 2. Mucus Glands
• Mucus glands are mainly made up of mucus cells.
• These glands secrete thick, viscous saliva with high mucin content. Lingual
mucus glands, buccal glands and palatal glands belong to this type.
• 3. Mixed Glands
• Mixed glands are made up of both serous and mucus cells. Submandibular,
sublingual and labial glands are the mixed glands.

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 PROPERTIES OF SALIVA
• 1000-1500 mL/per day of saliva is secreted and it is
approximately about 1 mL/minute.
• Mixed saliva from all the glands is slightly acidic with pH of 6.35-
6.85
• Specific gravity: It ranges between 1.002-1.012
• Tonicity: Saliva is hypotonic to plasma.
• Contribution by each major salivary gland is:
• i. Parotid glands : 25%
• ii. Submaxillary glands : 70%
• iii. Sublingual glands : 5%.
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 FUNCTIONS OF SALIVA
1. Preparation of food for swallowing
2. Appreciation of taste
3. Digestive function
4. Cleansing and protective functions
5. Role in speech
6. Excretory function
7. Regulation of body temperature
8. Regulation of water balance

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 FUNCTIONS OF SALIVA
• Salivais a very essential digestive juice. Since it has many
functions, its absence leads to many inconveniences.
• 1. PREPARATION OF FOOD FOR SWALLOWING
• It moistens and dissolves food and mucus membrane of mouth
• Facilitates chewing.
• The moistened and masticated food rolled into bolus.
• Mucin of saliva lubricates bolus and facilitates swallowing.

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•2. APPRECIATION OF TASTE
• Taste is achemical sensation.
• Saliva dissolves the solid food substances,
dissolved substances can stimulate the taste
buds.
• The stimulated taste buds recognize the taste.

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• 3. DIGESTIVE FUNCTION
• Saliva has three digestive enzymes, namely salivary amylase,
maltase and lingual lipase.
• Salivary Amylase
• It is a carbohydrate-digesting (amylolytic) enzyme.
• It acts on cooked or boiled starch and converts it into dextrin
and maltose.
• Though starch digestion starts in the mouth, major part of it
occurs in stomach because, food stays only for a short time in
the mouth.
• Optimum pH necessary for the activation of salivary amylase is
6.
• Salivary amylase cannot act on cellulose.
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• Salivary Maltase
• Maltaseis present only in traces in human saliva and it
converts maltose into glucose.
• Lingual Lipase
• Lingual lipase is a lipid-digesting (lipolytic) enzyme.
• It
is secreted from serous glands situated on the posterior
aspect of tongue. It digests milk fats (pre-emulsified
fats).
• It
hydrolyzes triglycerides into fatty acids and
diacylglycerol
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• 4.CLEANSING AND PROTECTIVE
FUNCTIONS
• Due to the constant secretion of saliva, the mouth and teeth
are rinsed and kept free off food debris, shed epithelial cells
and foreign particles.
• In this way, saliva prevents bacterial growth by removing
materials, which may serve as culture media for the
bacterial growth.
• ii.Enzyme lysozyme of saliva kills some bacteria such as
Staphylococcus, Streptococcus and Brucella.

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• iii.
Proline-rich proteins present in saliva posses
antimicrobial property and neutralize the toxic substances
such as tannins. Tannins are present in many food
substances including fruits.
• iv. Lactoferrin of saliva also has antimicrobial property.
• v.Proline-rich proteins and lactoferrin protect the teeth by
stimulating enamel formation.
• vi.
Immunoglobulin IgA in saliva also has antibacterial and
antiviral actions.
• vii.
Mucin present in the saliva protects the mouth by
lubricating the mucus membrane of mouth.
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• ROLE IN SPEECH
• Bymoistening and lubricating soft parts of mouth and lips, saliva
helps in speech. If the mouth becomes dry, articulation and
pronunciation becomes difficult.
• EXCRETORY FUNCTION
• Itexcretes substances like mercury, potassium iodide, lead, and
thiocyanate. Saliva also excretes some viruses such as those causing
rabies and mumps.
• In pathological condition:
• glucose in diabetes mellitus.
• excess urea is excreted in saliva during nephritis.
• excess calcium is excreted during hyperparathyroidism.
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 REGULATION OF SALIVARY SECRETION
•Autonomic nervous system is involved in the regulation of salivary
secretion.
•The facial nerve innervates the anterior (front) two-thirds of the tongue
and the glossopharyngeal nerve innervates that posterior (back) one-
third part of the tongue.
•Vagus nerve, X carries taste information from the back part of the
mouth.
•The trigeminal nerve, V also innervates the tongue, but is not used for
taste.
•Rather, the trigeminal nerve carries information related to touch,
pressure, temperature and pain.
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 PHARYNX
•When food is first swallowed, it passes from the mouth into the
pharynx (throat).
•Itis a funnel-shaped tube that extends from the internal nares to the
esophagus posteriorly and to the larynx anteriorly.
•Itis composed of skeletal muscle and lined by mucous membrane, and
is divided into three parts: the nasopharynx, the oropharynx, and the
laryngopharynx.
•The nasopharynx functions only in respiration, but both the
oropharynx and laryngopharynx have digestive as well as respiratory
functions.
•The muscular contractions of these areas help propel food into the
esophagus and then into the stomach.
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 ESOPHAGUS
•The esophagus is a collapsible muscular tube, about 25 cm
(10 in.) long, that lies posterior to the trachea.
•It begins at the inferior end of the laryngopharynx and
passes through the mediastinum anterior to the vertebral
column.
•Thenit pierces the diaphragm through an opening called the
esophageal hiatus, and ends in the superior portion of the
stomach

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 STOMACH
•Stomach is a hollow organ situated just below the
diaphragm on the left side in the abdominal
cavity.
•Volume of empty stomach is 50 mL.
•Under normal conditions, it can expand to
accommodate 1-1.5 L of solids and liquids.

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 PARTS OF STOMACH
•Stomach has four parts:
•1. Cardiac region
•2. Fundus
•3. Body or corpus
•4. Pyloric region.
•Stomach has two curvatures.
•One on the right side is lesser curvature and
the other on left side is greater curvature.
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• 1. Cardiac Region
• Cardiac
region is the upper part of the stomach where
esophagus opens.
• The opening is guarded by a sphincter called cardiac
sphincter, which opens only towards stomach. This
portion is also known as cardiac end.
• 2. Fundus
• Fundus is a small dome-shaped structure.
• It is elevated above the level of esophageal opening.

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• 3. Body or Corpus
• Largestpart of stomach forming about 75% to 80% of the whole
stomach.
• It extends from just below the fundus up to the pyloric region.
• 4. Pyloric Region
• Pyloric region has two parts, antrum and pyloric canal.
• The body of stomach ends in antrum. Antrum is continued as the
narrow canal, which is called pyloric canal or pyloric end.
• Pyloric canal opens into first part of small intestine called duodenum.
• Theopening of pyloric canal is guarded by a sphincter called pyloric
sphincter. It opens towards duodenum.
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 STRUCTURE OF STOMACH WALL
•Outer serous layer
•Muscular layer
•Submucus layer
•Inner mucus layer

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 FUNCTIONS OF STOMACH
1. Mixes bolus (saliva and food) and gastric juice to form
chyme.
2. Serves as a reservoir for food before release into small
intestine.
3. Secretes gastric juice, which contains HCl (kills bacteria
and denatures protein), pepsin (begins the digestion of
proteins), intrinsic factor (aids absorption of vitamin B12),
and gastric lipase (aids digestion of triglycerides).
4. Secretes gastrin into blood.

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 Types of cells in stomach
•Four major types of secretory epithelial cells cover the
surface of the stomach and extend down into gastric pits and
glands:
•Mucous cells: secrete an alkaline mucus that protects the
epithelium against shear stress and acid
•Parietal cells: secrete hydrochloric acid
•Chief cells: secrete pepsin, a proteolytic enzyme
•G cells: secrete the hormone gastrin

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 GLANDS OF STOMACH –GASTRIC GLANDS
•Function of the gastric gland is to secrete gastric juice.
•Gastric glands are classified into three types, on the basis of
their location in the stomach:
•1. Fundic glands or main gastric glands or oxyntic glands:
•Situated in body and fundus of stomach
•2. Pyloric glands:
•Present in the pyloric part of the stomach
•3. Cardiac glands:
•Located in the cardiac region of the stomach.

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 CELL present in stomach SECRETORY PRODUCTS
CHIEF CELLS PEPSINOGEN,
RENNIN,
LIPASE,
GELATINASE,
URASE
PARIETAL CELLS HYDROCHLORIC ACID,
INTRINSIC FACTOR OF CASTLE
MUCUS NECK CELLS MUCIN
G CELLS GASTRIN
ENTEROCHROMAFFIN SEROTONIN
CELLS
ENTEROCHROMAFFIN-LIKE HISTAMINE
CELLS
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 Enteroendocrine Cells
•Enteroendocrine cells are the hormone secreting cells
present in the glands or mucosa of gastrointestinal tract,
particularly stomach and intestine.
•The enteroendocrine cells present in gastric glands are
G cells, EC cells and ECL cells

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 PROPERTIES OF GASTRIC JUICE
•Volume : 1200-1500 mL/day.
•Reaction : Gastric juice is highly acidic with
a pH of 0.9 to 1.2. Acidity of gastric juice is
due to the presence of hydrochloric acid.
•Specific gravity : 1.002 to 1.004

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 FUNCTIONS OF GASTRIC JUICE
•1. DIGESTIVE FUNCTION
•Gastric juice acts mainly on proteins.
•Proteolytic enzymes of the gastric juice are pepsin and rennin.
•Gastric juice also contains some other enzymes like gastric lipase,
gelatinase, urase and gastric amylase.
•Pepsin
•It is secreted as inactive pepsinogen. Pepsinogen is converted into
pepsin by hydrochloric acid. Optimum pH for activation of pepsinogen is
below 6.
•Pepsin converts proteins into proteoses, peptones and polypeptides.
Pepsin also causes curdling and digestion of milk (casein, a milk protein)
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• Gastric Lipase
• Gastric
lipase is a weak lipolytic enzyme when
compared to pancreatic lipase.
• It
is active only when the pH is between 4 and 5 and
becomes inactive at a pH below 2.5.
• Gastric lipase is a tributyrase and it hydrolyzes
tributyrin (butter fat) into fatty acids and glycerols.

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 Other Enzymes of Gastric Juice
i. Gelatinase: Degrades type I and type V gelatin and type IV
and V collagen (which are proteoglycans in meat) into
peptides
ii. Urase: Acts on urea and produces ammonia
iii. Gastric amylase: Degrades starch (but its action is
insignificant)
iv. Rennin: Curdles milk (present in animals only).

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 Gastric acid secretion
• The secretion of gastric juice is controlled by both nerves
and hormones.
• Stimuli in the brain, stomach, and small intestine activate or
inhibit gastric juice production.
• This is why the three phases of gastric secretion are called
the cephalic, gastric, and intestinal phases.
• Once gastric secretion begins, all three phases can occur
simultaneously.

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 The cephalic phase
•Also called as reflex phase of gastric secretion, which is relatively
brief, takes place before food enters the stomach.
•The smell, taste, sight, or thought of food triggers this phase.
•For example, when you bring a piece of cake to your lips, impulses
from receptors in your taste buds or the nose are relayed to your
brain, which returns signals that increase gastric secretion to prepare
your stomach for digestion.
•This enhanced secretion is a conditioned reflex, meaning it occurs
only if you like or want a particular food.
•Depression and loss of appetite can suppress the cephalic reflex.

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 The gastric phase
•Secretion lasts 3 to 4 hours, and is set in action by local neural and hormonal mechanisms
triggered by the entry of food into the stomach.
•For example, when the cake piece reaches the stomach, it creates distention that activates
the stretch receptors. This stimulates parasympathetic neurons to release acetylcholine,
which then provokes increased secretion of gastric juice.
•Partiallydigested proteins, caffeine, and rising pH stimulate the release of gastrin from
enteroendocrine G cells, which in turn induces parietal cells to increase their production of
HCl, which is needed to create an acidic environment for the conversion of pepsinogen to
pepsin, and protein digestion.
•Additionally, the release of gastrin activates vigorous smooth muscle contractions.
•The stomach does have a natural means of avoiding excessive acid secretion and potential
heartburn.
•Whenever pH levels drop too low, cells in the stomach react by suspending HCl secretion
and increasing mucous secretions.

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 The intestinal phase
•Gastric secretion has both excitatory and inhibitory elements.
•The duodenum has a major role in regulating the stomach and its
emptying.
•When partially digested food fills the duodenum, intestinal mucosal
cells release a hormone called intestinal (enteric) gastrin, which further
excites gastric juice secretion.
•This stimulatory activity is brief, because when the intestine distends
with chyme, the enterogastric reflex inhibits secretion.
•One of the effects of this reflex is to close the pyloric sphincter, which
blocks additional chyme from entering the duodenum.

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 GI hormones which inhibit gastric secretion
• i. Secretin: Secreted by the presence of acid chyme in the intestine
• ii. Cholecystokinin: Secreted by the presence of chyme containing
fats and amino acids in intestine
•iii. Gastric inhibitory peptide (GIP): Secreted by the presence of
chyme containing glucose and fats in the intestine
•iv.Vasoactive intestinal polypeptide (VIP): Secreted by the
presence of acidic chyme in intestine
•v. Peptide YY: Secreted by the presence of fatty chyme in intestine.
• vi. Somatostatin during intestinal phase.

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 PANCREAS
•From the stomach, chyme passes into the
small intestine.
•Because chemical digestion in the small
intestine depends on activities of the pancreas,
liver, and gallbladder, the activities of these
accessory digestive organs and their
contributions to digestion in the small
intestine.

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 ANATOMY OF PANCREAS
•Itretroperitoneal gland that is about 12–15 cm (5–6 in.)
long and 2.5 cm (1 in.) thick, lies posterior to the greater
curvature of the stomach.
•Itconsists of a head, a body, and a tail and is usually
connected to the duodenum by two ducts.
•Itis a dual organ having two functions, namely endocrine
function and exocrine function. Endocrine function is
concerned with the production of hormones.
•The exocrine function is concerned with the secretion of
digestive juice called pancreatic juice.
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 diaphragm

liver

Gall bladder

pancreas

Small intestine

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 Anatomy of the Pancreas
•The pancreas is made up of small clusters of glandular epithelial
cells.
•About 99% of the clusters, called acini, constitute the exocrine
portion of the organ.
•The cells within acini secrete a mixture of fluid and digestive
enzymes called pancreatic juice.
•The remaining 1% of the clusters, called pancreatic islets (islets
of Langerhans), form the endocrine portion of the pancreas.
•These cells secrete the hormones glucagon, insulin, somatostatin,
and pancreatic polypeptide.

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 PROPERTIES OF PANCREATIC JUICE
•Volume : 500 to 800 mL/day
•Reaction : Highly alkaline with a pH of 8 to 8.3
•Specific gravity : 1.010 to 1.018
COMPOSITION OF PANCREATIC JUICE
•Pancreaticjuice contains 99.5% of water and 0.5% of solids. The solids are the
organic and inorganic substances.
•Bicarbonate content is very high in pancreatic juice
•i. High bicarbonate content makes the pancreatic juice highly alkaline, so
that it protects the intestinal mucosa from acid chyme by neutralizing it
•ii. Bicarbonate
ions provide the required pH (7 to 9) for the activation of
pancreatic enzymes.

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17/03/23 Prepared by Mrs. K. Gladys Kalpana M.Pharm 78
 FUNCTIONS OF PANCREATIC JUICE
•Digestive functions of pancreatic juice
•Pancreaticjuice plays an important role in the digestion of
proteins and lipids. It also has mild digestive action on
carbohydrates.
•Digestion of proteins
•Major proteolytic enzymes of pancreatic juice are trypsin and
chymotrypsin. Other proteolytic enzymes are carboxypeptidases,
nuclease, elastase and collagenase.

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• 1. Trypsin
• Trypsinis a single polypeptide with a molecular weight of 25,000. It
contains 229 amino acids.
• Itis secreted as inactive trypsinogen, which is converted into active
trypsin by enterokinase.
• Enterokinase is also called enteropeptidase and it is secreted by the
brush-bordered cells of duodenal mucus membrane. Once formed,
trypsin itself activates trypsinogen by means of autocatalytic or
autoactive action.
• It is activated only when it reaches small intestine.
• its
activation in the secretory cells, acini and ducts of pancreas is
prevented by an inhibitor protein called trypsin inhibitor.
17/03/23 Prepared by Mrs. K. Gladys Kalpana M.Pharm 80
• Actions of trypsin
• i. Digestion of proteins: Trypsin is the most powerful proteolytic enzyme. It is an
endopeptidase and breaks the interior bonds of the protein molecules and converts
proteins into proteoses and polypeptides
• ii. Curdling of milk: It converts caseinogen in the milk into casein
• iii. Blood clotting: It accelerates blood clotting iv. It activates the other enzymes of
pancreatic juice, viz.
• a. Chymotrypsinogen into chymotrypsin
• b. Procarboxypeptidases into carboxypeptidases
• c. Proelastase into elastase
• d. Procolipase into colipase
• v. Trypsin also activates collagenase, phospholipase A and phospholipase B
• vi. Autocatalytic action: Once formed, trypsin itself converts trypsinogen into trypsin.
17/03/23 Prepared by Mrs. K. Gladys Kalpana M.Pharm 81
• 2. Chymotrypsin
• Chymotrypsin is a polypeptide with a molecular weight of 25,700 and
246 amino acids.
• It
is secreted as inactive chymotrypsinogen, which is activated into
chymotrypsin by trypsin.
• Actions of chymotrypsin
• i.
Digestion of proteins: Chymotrypsin is also an endopeptidase
and it converts proteins into polypeptides
• ii.
Digestion of milk: Chymotrypsin digests caseinogen faster than
trypsin. Combination of both enzymes causes rapid digestion of milk

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• 3. Carboxypeptidases
• Carboxypeptidases are carboxypeptidase A and carboxypeptidase B.
• Carboxypeptidase A is derived from the precursor procarboxypeptidase A.
• Carboxypeptidase B is derived from procarboxypeptidase B.
• Procarboxypeptidases are activated into carboxypeptidases by trypsin.
• Carboxypeptidases are exopeptidases and break the terminal bond of
protein molecules. Exopeptidases split the polypeptides and other
proteins into amino acids.
• Carboxypeptidase A splits the proteins into amino acids having aromatic
or aliphatic side chains.
• Carboxypeptidase B converts the proteins into amino acids having basic
side chains.
17/03/23 Prepared by Mrs. K. Gladys Kalpana M.Pharm 83
• 4. Nucleases
• Nucleases of pancreatic juice are ribonuclease and
deoxyribonuclease, which are responsible for the digestion of
nucleic acids.
• These enzymes convert the ribonucleic acid (RNA) and
deoxyribonucleic acid (DNA) into mononucleotides.
• 5. Elastase
• Elastase is secreted as inactive proelastase, which is activated into
elastase by trypsin. Elastase digests the elastic fibers.
• 6. Collagenase
• Collagenase is secreted as inactive procollagenase, which is
activated into collagenase by trypsin. It digests collagen.
17/03/23 Prepared by Mrs. K. Gladys Kalpana M.Pharm 84
 DIGESTION OF LIPIDS
•Lipolyticenzymes present in pancreatic juice are pancreatic lipase, cholesterol
ester hydrolase, phospholipase A, phospholipase B, colipase and bile salt activated
lipase.
•1. Pancreatic lipase
•Pancreaticlipase is a powerful lipolytic enzyme. It digests triglycerides into
monoglycerides and fatty acids.
•Activityof pancreatic lipase is accelerated in the presence of bile. Optimum pH
required for activity of this enzyme is 7-9.
•Digestion of fat by pancreatic lipase requires two more factors:
•i.Bile salts, which are responsible for the emulsification of fat, prior to their
digestion.
•ii.
Colipase, which is a coenzyme necessary for the pancreatic lipase to digest the
dietary lipids.
17/03/23 Prepared by Mrs. K. Gladys Kalpana M.Pharm 85
• 2. Cholesterol ester hydrolase
• Cholesterol ester hydrolase or cholesterol esterase converts cholesterol ester into
free cholesterol and fatty acid by hydrolysis.
• 3. Phospholipase A
• Phospholipase A is activated by trypsin. Phospholipase A digests phospholipids,
namely lecithin and cephalin and converts them into lysophospholipids. It
converts lecithin into lysolecithin and cephalin into lysocephalin.
• 4. Phospholipase B
• Phospholipase B is also activated by trypsin. It converts lysophospholipids
(lysolecithin and lysocephalin) to phosphoryl choline and free fatty acids.
• 5. Colipase
• Colipase is a small coenzyme, secreted as inactive procolipase. Procolipase is
activated into colipase by trypsin. Colipase facilitates digestive action of
pancreatic lipase on fats.
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• 6. Bile-salt-activated lipase
• Bile salt activated lipase is the lipolytic enzyme
activated by bile salt. It is also called carboxyl ester
lipase or cholesterol esterase.
• This enzyme has a weak lipolytic action than
pancreatic lipase.
• But it hydrolyses a variety of lipids such as
phospholipids, cholesterol esters and triglycerides.
• Human milk contains an enzyme similar to bile-salt-
activated lipase.

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 DIGESTION OF CARBOHYDRATES
•Pancreatic amylase is the amylolytic enzyme present in pancreatic juice.
•Like salivary amylase, the pancreatic amylase also converts starch into
dextrin and maltose.
•Neutralizing action of pancreatic juice
•When acid chyme enters intestine from stomach, pancreatic juice with large
quantity of bicarbonate is released into intestine.
•Presence of large quantity of bicarbonate ions makes the pancreatic juice
highly alkaline. This alkaline pancreatic juice neutralizes acidity of chyme in
the intestine.
•Neutralizing action is an important function of pancreatic juice because it
protects the intestine from the destructive action of acid in the chyme.
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 REGULATION OF PANCREATIC SECRETION
•Secretionof pancreatic juice is regulated by both nervous and
hormonal factors.
•STAGES OF PANCREATIC SECRETION
•Pancreatic juice is secreted in three stages like the gastric juice:
•1. Cephalic phase
•2. Gastric phase
•3. Intestinal phase.
•These three phases of pancreatic secretion correspond with the
three phases of gastric secretion.

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•1. CEPHALIC PHASE
•As in case of gastric secretion, cephalic phase is
regulated by nervous mechanism through
reflex action.
•Two types of reflexes occur:
•1. Unconditioned reflex
•2. Conditioned reflex.

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• Unconditioned Reflex
• Unconditioned reflex isthe inborn reflex. When food is placed in the
mouth, salivary secretion and gastric secretion are induced.
• Simultaneously, pancreatic secretion also occurs.
• Stages of reflex action:
• i.
Presence of food in the mouth stimulates the taste buds and other
receptors in the mouth.
• ii.
Sensory (afferent) impulses from mouth reach dorsal nucleus of
vagus and efferent impulses reach pancreatic acini via vagal efferent
nerve fibers
• iii. Vagal
efferent nerve endings secrete acetylcholine, which
stimulates pancreatic secretion.
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• Conditioned Reflex
• Conditioned reflex is the reflex response acquired by previous experience.
Presence of food in the mouth is not necessary to elicit this reflex.
• The sight, smell, hearing or thought of food, which induce salivary secretion and
gastric secretion induce pancreatic secretion also.
• Stages of reflex action:
• i. Impulses from the special sensory organs (eye, ear and nose) pass through
afferent fibers of neural circuits to the cerebral cortex. Thinking of food stimulates
the cerebral cortex directly
• ii. From cerebral cortex, the impulses pass through dorsal nucleus of vagus and
vagal efferents and reach pancreatic acini
• iii. Vagal nerve endings secrete acetylcholine, which stimulates pancreatic
secretion.

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• 2. GASTRIC PHASE
• Secretion of pancreatic juice when food enters the stomach is known as gastric
phase.
• This phase of pancreatic secretion is under hormonal control. The hormone
involved is gastrin.
• When food enters the stomach, gastrin is secreted from stomach. When gastrin is
transported to pancreas through blood, it stimulates the pancreatic secretion.
• The pancreatic juice secreted during gastric phase is rich in enzymes.
• 3. INTESTINAL PHASE
• Intestinal phase is the secretion of pancreatic juice when the chyme enters the
intestine. This phase is also under hormonal control.
• When chyme enters the intestine, many hormones are released. Some hormones
stimulate the pancreatic secretion and some hormones inhibit the pancreatic
secretion.
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• Hormones Stimulating Pancreatic Secretion
• i. Secretin
• ii. Cholecystokinin.
• Secretin
• Secretin is produced by S cells of mucous membrane in duodenum and
jejunum. It is secreted as inactive prosecretin, which is activated into
secretin by acid chyme.
• The
stimulant for the release and activation of prosecretin is the acid
chyme entering intestine.
• Products of protein digestion also stimulate the hormonal secretion.
• Secretin stimulates the secretion of watery juice which is rich in of
bicarbonate ion and high in volume. It increases the pancreactic
secretion
17/03/23 by acting on pancreatic ductules
Prepared by Mrs. K. via cyclic AMP (messenger).
Gladys Kalpana M.Pharm 94
• Cholecystokinin
• Also called as cholecystokinin pancreozymin (CCKPZ).
• It is secreted by I cells in duodenal and jejunal mucosa.
• The stimulant for the release of this hormone is the chyme
containing digestive products such as fatty acids, peptides and
amino acids.
• Action of cholecystokinin
• Cholecystokinin stimulates the secretion of pancreatic juice which
is rich in enzyme and low in volume, by acting on pancreatic acinar
cells via inosine triphosphate (second messenger).

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 LIVER
•The liver is the heaviest gland of the body, weighing about 1.4
kg.
•The liver is inferior to the diaphragm and occupies most of the
right hypochondriac and part of the epigastric regions of the
abdominopelvic cavity.
•The liver is divided into two principal lobes, a large right lobe
and a smaller left lobe by the falciform ligament.
•Hepatic lobes are made of lobule.
•Hepaticlobule is a honeycomb-like structure and it is
made up of liver cells called hepatocytes.
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17/03/23 Prepared by Mrs. K. Gladys Kalpana M.Pharm 97
 Left lobe

Right lobe

Hepatic artery Inferior vena cava

Gall bladder
Hepatic portal vein

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 FUNCTIONS OF LIVER
•METABOLIC FUNCTION
•Liver is the organ where maximum metabolic reactions such as metabolism
of carbohydrates, proteins, fats, vitamins and many hormones are carried
out.
•STORAGE FUNCTION
•Many substances like glycogen, amino acids, iron, folic acid and vitamins A,
B12 and D are stored in liver.
•SYNTHETIC FUNCTION
•Liver produces glucose by gluconeogenesis. It synthesizes all the plasma
proteins and other proteins (except immunoglobulins) such as clotting
factors, complement factors and hormone binding proteins. It also
synthesizes steroids, somatomedin and heparin.

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• HEAT PRODUCTION
• Enormous amount of heat is produced in the liver because of metabolic
reactions. Liver is the organ where maximum heat is produced.
• HEMOPOIETIC FUNCTION
• In fetus (hepatic stage), liver produces the blood cells (Chapter 10). It
stores vitamin B12 necessary for erythropoiesis and iron necessary for
synthesis of hemoglobin. Liver produces thrombopoietin that promotes
production of thrombocytes.
• HEMOLYTIC FUNCTION
• The senile RBCs after a lifespan of 120 days are destroyed by reticulo-
endothelial cells (Kupffer cells) of liver.

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• INACTIVATION OF HORMONES AND
DRUGS
• Liver catabolizes the hormones such as growth
hormone, parathormone, cortisol, insulin, glucagon
and estrogen.
• It also inactivates the drugs.
• DEFENSIVE AND DETOXIFICATION
FUNCTIONS
• Reticuloendothelial cells (Kupffer cells) of the liver
play an important role in the defense of the body

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 BLOOD SUPPLY TO LIVER
•HEPATIC ARTERY
•It receives blood from two sources, namely the hepatic artery and portal vein.
•Hepatic artery arises directly from aorta and supplies oxygenated blood to
liver.
•Afterentering the liver, the hepatic artery divides into many branches. Each
branch enters a portal triad.
•HEPATIC VEIN
•Substances synthesized by hepatic
cells, waste products and carbon dioxide are
discharged into sinusoids. Sinusoids drain them into central vein of the lobule.
•Central veins from many lobules unite to form bigger veins, which ultimately form
hepatic veins (right and left) which open into inferior vena cava.

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17/03/23 Prepared by Mrs. K. Gladys Kalpana M.Pharm 103
 PORTAL VEIN
•Portal vein is formed by superior mesenteric vein and
splenic vein. It brings deoxygenated blood from
stomach, intestine, spleen and pancreas.
•Portalblood is rich in monosaccharides and amino acids. It
also contains bile salts, bilirubin, urobilinogen and GI
hormones. However, the oxygen content is less in portal
blood.
•Flowof blood from intestine to liver through portal vein is
known as enterohepatic circulation.

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 GALL BLADDER
•The gallbladder (gall- bile) is a pear-
shaped sac that is located in a depression
of the posterior surface of the liver.
•It is 7–10 cm (3–4 in.) long and typically
hangs from the anterior inferior margin of
the liver.

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 BILE
•Bileis a dark green to yellowish brown fluid, produced by the liver that aids the
digestion of lipids in the small intestine.
•Bile is continuously by the liver, stored and concentrated in gall bladder.
•After eating, the stored bile is discharged into intestine (duodenum).
•PROPERTIES OF BILE
•Volume : 800 to 1,200 mL/day
•Reaction : Alkaline
•pH : 8 to 8.6
•Specific gravity : 1.010 to 1.011
•Color : Golden yellow or green.

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17/03/23 Prepared by Mrs. K. Gladys Kalpana M.Pharm 107
 Small Intestine
•Smallintestine is the part of gastrointestinal (GI) tract, extending
between the pyloric sphincter of stomach and ileocecal valve,
which opens into large intestine.
•Most digestion and absorption of nutrients occur in the small
intestine.
•Because, Its length provides a large surface area for digestion and
absorption, and that area is further increased by circular folds, villi, and
microvilli.
•Thesmall intestine is divided into three regions, the duodenum,
jejunum and ileum.

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17/03/23 Prepared by Mrs. K. Gladys Kalpana M.Pharm 109
 Histology of the Small Intestine
•Thewall of the small intestine is composed of the same four layers that make
up most of the GI tract: mucosa, submucosa, muscularis, and serosa.
•Themucosa is composed of a layer of epithelium, lamina propria, and
muscularis mucosae.
•The epithelial layer of the small intestinal mucosa consists of simple columnar
epithelium that contains many types of cells.
•Absorptive cells of the epithelium digest and absorb nutrients in small
intestinal chyme.
•Gobletcells, which secrete mucus. The small intestinal mucosa contains
many deep crevices lined with glandular epithelium.
•Paneth cells secrete lysozyme, a bactericidal enzyme, and are capable of
phagocytosis.

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• Three types ofenteroendocrine cells are found in the intestinal
glands of the small intestine: S cells, CCK cells, and K cells,
which secrete the hormones secretin, cholecystokinin or CCK,
and glucose-dependent insulinotropic peptide or GIP,
respectively.
• Also present in the small intestine are villi ( tufts of hair), which
are finger-like projections of the mucosa that are 0.5–1 mm long.
• Villi helps
in absorption and digestion and gives the intestinal
mucosa a velvety appearance.
• Besides
circular folds and villi, the small intestine also has
microvilli (brush-border) containing several brush-border
enzymes that have digestive functions.
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 Mechanical Digestion in the Small Intestine
•The two types of movements of the small intestine—segmentations and a type of
peristalsis called migrating motility complexes.
•Segmentations mix chyme with the digestive juices and bring the particles of food
into contact with the mucosa for absorption.
•After most of a meal has been absorbed, which lessens distension of the wall of the
small intestine, segmentation stops and migrating motility complex begins.
•Secretion from small intestine is called succus entericus.
•Properties Of Succus Entericus
•Volume : 1800 mL/day
•Reaction : Alkaline
•pH : 8.3

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 Chemical Digestion in the Small Intestine
•Chyme entering the small intestine contains partially digested carbohydrates,
proteins, and lipids.
•The completion of the digestion of carbohydrates, proteins, and lipids is a
collective effort of pancreatic juice, bile, and intestinal juice in the small intestine.
•Digestion of Carbohydrates
•Those starches not already broken down into maltose, maltotriose, and a-dextrins
are cleaved by pancreatic amylase, an enzyme in pancreatic juice that acts in
the small intestine.
•After amylase has split starch into smaller fragments, a brush-border enzyme
called -dextrinase acts on the resulting a-dextrins, clipping off one glucose unit
at a time.
•Ingested molecules of sucrose, lactose, and maltose—three disaccharides—are not
acted on until they reach the small intestine.
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• Threebrush-border enzymes digest the disaccharides into
monosaccharides.
• Sucrase breaks sucrose into a molecule of glucose and a
molecule of fructose;
• lactase digests lactose into a molecule of glucose and a
molecule of galactose; and
• maltase splits maltose and maltotriose into two or three
molecules of glucose, respectively.
• Digestion
of carbohydrates ends with the production of
monosaccharides, which the digestive system is able to absorb.

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• Digestion of Proteins
• Protein digestion is completed by two peptidases in the brush
border: aminopeptidase and dipeptidase.
• Aminopeptidase cleaves off the amino acid at the amino end of a
peptide.
• Dipeptidase splits dipeptides (two amino acids joined by a peptide
bond) into single amino acids.
• Digestion of Lipids
• largelipid globule is broken apart into several small lipid globules,
each about 1 m in diameter.
• The small lipid globules formed from emulsification provide a large
surface area that allows pancreatic lipase to function more effectively.
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• Absorption in the Small Intestine
• Passage of digested nutrients from the gastrointestinal tract
into the blood or lymph is called absorption.
• Absorption of materials occurs via diffusion, facilitated
diffusion, osmosis, and active transport. About 90% of all
absorption of nutrients occurs in the small intestine; the
other 10% occurs in the stomach and large intestine.
• Any undigested or unabsorbed material left in the small
intestine passes on to the large intestine.

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• Absorption of monosaccharides is done by facilitated
diffusion.
• Absorption of amino acids, dipeptides and tripeptides
via active transport
• Absorption of lipids via simple diffusion.
• Absorption of electrolytes via active transport.
• Absorption of vitamins via simple diffusion and active
transport
• Absorption of water via osmosis

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 LARGE INTESTINE
•The large intestine is the terminal portion of the GI tract.
•fourmajor regions of the large intestine are the cecum, colon, rectum, and anal
canal.
•The
opening from the ileum into the large intestine is guarded by a fold of mucous
membrane called the ileocecal sphincter (valve).
•Hanging inferior to the ileocecal valve is the cecum, a small pouch about 6 cm
long.
•Attached to the cecum is a twisted, coiled tube, measuring about 8 cm (3 in.) in
length, called the appendix or vermiform appendix
•The open end of the cecum merges with a long tube called the colon which is
divided into ascending, transverse, descending, and sigmoid colons.

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• Large intestine is made up of the following parts:
• 1. Cecum with appendix
• 2. Ascending colon
• 3. Transverse colon
• 4. Descending colon
• 5. Sigmoid colon or pelvic colon
• 6. Rectum
• 7. Anal canal.

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 TRANSVERSE COLON

DESCENDING COLON

ASCENDING COLON

Ileum

RECTUM

APPENDIX ANAL CANAL

ANUS
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 COMPOSITION OF LARGE INTESTINAL JUICE
•Large intestinal juice is a watery fluid with pH of 8.0
•Large intestinal juice contains 99.5% of water and 0.5% of solids. Digestive
enzymes are absent and concentration of bicarbonate is high in large intestinal
juice.
•Large intestine plays an important role in the absorption of various substances
such as:
•i. Water
•ii. Electrolytes

•iii. Organic substances like glucose

•iv. Alcohol

•v. Drugs like anesthetic agents, sedatives and steroids.

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• After the absorption of nutrients, water and other substances,
the unwanted substances in the large intestine form feces. This
is excreted out.
• Largeintestine excretes heavy metals like mercury, lead,
bismuth and arsenic through feces.
• Large intestine secretes mucin and inorganic substances like
chlorides and bicarbonates.
• Bacterial
flora of large intestine synthesizes folic acid, vitamin
B12 and vitamin K. By this function, large intestine contributes
in erythropoietic activity and blood clotting mechanism.

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 Movements of Gastrointestinal tract
•MASTICATION
•Mastication or chewing is the first mechanical process in
the gastrointestinal (GI) tract, by which the food substances
are torn or cut into small particles and crushed or ground
into a soft bolus.
•1. Breakdown of foodstuffs into smaller particles
•2. Mixing of saliva with food substances thoroughly
•3.Lubrication and moistening of dry food by saliva, so that
the bolus can be easily swallowed
•4. Appreciation of taste of the food.
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 DEGLUTITION
•Deglutitionor swallowing is the process by which food
moves from mouth into stomach.
•Stages of Deglutition
•Deglutition occurs in three stages:
•I. Oral stage, when food moves from mouth to pharynx
•II.Pharyngeal stage, when food moves from pharynx to
esophagus
•III.
Esophageal stage, when food moves from esophagus to
stomach.
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 MOVEMENTS OF STOMACH
•Activities
of smooth muscles of stomach increase during gastric
digestion (when stomach is filled with food) and when the
stomach is empty.
•1. HUNGER CONTRACTIONS
•Hunger contractions are the movements of empty stomach.
These contractions are related to the sensations of hunger.
•2. RECEPTIVE RELAXATION
•Receptive relaxation is the relaxation of the upper portion of
the stomach when bolus enters the stomach from esophagus. It
involves the fundus and upper part of the body of stomach.

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• 3. PERISTALSIS
• When food enters the stomach, the peristaltic contraction or peristaltic wave
appears with a frequency of 3 per minute.
• It starts from the lower part of the body of stomach, passes through the
pylorus till the pyloric sphincter.
• EMPTYING OF STOMACH
• Gastric emptying is the process by which the chime from stomach is emptied
into intestine.
• Food that is swallowed enters the stomach and remains there for about 3
hours.
• During this period, digestion takes place. Partly digested food in stomach
becomes the chime.

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 MOVEMENTS OF SMALL INTESTINE
•Movements of small intestine are essential for mixing the chyme with digestive juices,
propulsion of food and absorption.
•Types of Movements of Small Intestine
•Movements of small intestine are of four types:
•1. Mixing movements:

•i. Segmentation movements, ii. Pendular movements.

•2. Propulsive movements:

•i. Peristaltic movements, ii. Peristaltic rush.

•3. Peristalsis in fasting – migrating motor complex
•4. Movements of villi.

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 • MOVEMENTS OF LARGE INTESTINE
• Usually, the large intestine shows sluggish movements.
• Still,
these movements are important for mixing, propulsive
and absorptive functions.
• Types of Movements of Large Intestine
• Movements of large intestine are of two types:
• 1. Mixing movements: Segmentation contractions
• 2. Propulsive movements: Mass peristalsis.

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 DEFECATION
•Voiding of feces is known as defecation.
•Fecesis formed in the large intestine and stored in
sigmoid colon.
•By the influence of an appropriate stimulus, it is
expelled out through the anus.
•This is prevented by tonic constriction of anal
sphincters, in the absence of the stimulus.

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 Disorders of Digestive System
•Acute gastritis, Chronic gastritis
•Peptic ulcer
•Zollinger­-Ellison syndrome
•Gastric atrophy
•Pancreatitis

•Steatorrhea

•Hepatitis

•Jaundice

•Liver cirrhosis
•Gall stones
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