SMALL

INTESTINE
 FUNCTIONAL ANATOMY
• Small intestine is a part of GI tract, extending
between the pyloric sphincter of stomach to
ileocecal valve, which open into large intestine.
• It is called small intestine because of its small
diameter
• But its longer than large intestine
• Length is about 6 meter
• Important function of small intestine is
absorption.
• Maximum absorption of digested food is take
place in small intestine
• Small intestine consist of 3 portions;
üProximal part- duodenum
üMiddle part- jejunum
üDistal part- ileum
 INTESTINAL VILLI
• Mucous membrane of small intestine is covered by
minute projections called villi
• Height of villi is about 1mm and diameter is less than
1mm
• Villi are lined by columnar cells which are called
enterocytes.
• Each enterocytes give rise to hair like projections
called microvilli
• Villi and microvilli increases the surface area of
mucous membrane by many folds
• With in each villus many central channel called lacteal
which open into lymphatic vessels
• It contains blood vessels also
 CRYPTS OF
LIEBERKUHN/INTESTINAL GLAND
• Are simple tubular glands of intestine
• Intestinal glands does not penetrate the intestinal
mucosa of the intestinal wall but open into the
lumen of the intestine between the villi
• Intestine glands are lined by columnar cells
• Lining of each gland is continues
• with the epithelial lining of villi
•
• Epithelial lining od the intestinal glands undergo
division by mitosis
• The newly formed cells push the older cells upwards
• This cells are called enterocytes
• Enterocytes secrete enzymes
• Old enterocytes are continually shed into lumen
along with enzyme
• Types of cells interpose between columnar cells of
intestinal glands;
ü Argentaffin cells or enterochromaffin cells, which
secrete intrinsic factor of castle
• Goblet cells, secrete mucus
• Paneth cells, secrete the secrete the cytokines
called defensins
•
 BRUNNER GLANDS
• First part of duodenum contains some mucus
glands, which are called Brunner gland
• These glands penetrate muscularis mucosa and
extend upto the submucus coat of intestinal wall
• Brunner gland open into the lumen of intestine
directly
• Brunner gland secrete mucus and traces of enzymes
•
 PROPERTIES OF SUCCUS
ENTERICUS
• VOLUME – 1800 ML/DAY
•
• REACTION- ALKALINE
•
• PH- 8.3
 FUNCTIONS OF SUCCUS ENTERICUS
1.DIGESTIVE FUNCTION
• Enzymes of succuss entericus act on the
partially digested food and covert them to
final digestive products
• Enzymes are produced and released into
succuss entericus by enterocytes of the
villi
• A. PROTEOLYTIC ENZYMES
v Proteolytic enzyme present is peptidases
v These peptidase convert peptides into amino acids
• AMYLOTIC ENZYMES
v Lactase,sucrase and maltase convert the
disaccharides( lactose, sucrose and maltose) into
two molecules of monosaccharides.
v Dextrinase converts dextrin, maltose and maltriose
into glucose
v Trehalase or trehalose glucohydrolase causes
hydrolysis of trehalose (carbohydrate present in
the mushroom and yeast) and convert into glucose

• LIPOLYTIC ENZYME
v Intestinal lipase act on triglycerides and coverts
them into fatty acids
• 2.PROTECTIVE FUNCTIONS
vmucus present in the succuss entericus
protect the intestinal wall from the acid
chyme, which enters the intestine from
stomach thus prevents intestinal ulcer
vDefensins secreted from Paneth cells of
intestinal glands are antimicrobial
peptides
vThese peptides are called natural peptide
antibiotics bcz of their role in killing the
phagocyted bacteria
3.ACTIVATOR FUNCTION
• Enterokinase present in intestinal juice
activates trypsinogen into trypsin
• Trypsin in turn activates other enzymes
4.HEMOPOIETIC FUNCTION
• Intrinsic factor of castle present in the
intestine plays an important role in
erythropoiesis
• it is necessary for the absorption of vitamin
B12
5.HYDROLYTIC PROCESS
• Intestinal juice helps in all the enzymatic
reactions of digestion.
FUNCTIONS OF SMALL INTESTINE
• 1.MECHANICAL FUNCTION
Ømixing movements of the small intestine help the
thorough mixing of the chyme with the digestive
juices like succuss entericus, pancreatic juice and
bile
• 2.SECRETORY FUNCTION
ØSmall intestine secretes Succuss entericus ,
Enterokinase and GI hormones
• 3.HORMONAL FUNCTION
ØSmall intestine secretes many GI hormones such as
secretin , cholecystokinin etc. These hormones
regulates the movement of GI tract and secretory
activities of small intestine and pancreas
• 4.DIGESTIVE FUNCTIONS
• 5.ACTIVATOR FUNCTION
• 6.HEMOPOIETIC FUNCTION
• 7.HYDROLYTIC FUNCTION
• 8.ABSORPTIVE FUNCTION
üPresence of villi and microvilli in small
intestinal mucosa increases the surface
area of mucosa
üThis facilitate the absorptive function of
intestine
üDigested products of food stuffs ,proteins ,
carbohydrates and fats other nutritive
substances such as vitamins ,minerals and
water are absorbed mostly in small intestine .
üFrom the lumen of intestine substances passes
through lacteal of villi, cross the mucosa and
enter the blood directly through lymphatics
1. Absorption of carbohydrates
2. Absorption of proteins
3. Absorption of fats
4.Absorption of water and minerals
i. In small intestine sodium is absorbed
actively.it is responsible for the absorption
of glucose, amino acids and other
substances by means of sodium co-
transport
ii. Water moves in or out of the intestinal lumen
until the osmotic pressure of the intestinal
contents become equal to that plasma
iii. In ileum ,chloride ion is actively absorbed in
exchange of bicarbonates. The
significance of this exchange is not known.
iv. Calcium is actively absorbed mostly in upper
part of small intestine
v.
• Absorption of vitamins :
ØMost of the vitamins are absorbed in upper
part of small intestine and vitamin B12 is
absorbed in ileum
ØAbsorption of water soluble vitamin is
faster than fat soluble vitamins
 REGULATION OF SECRETION OF
SUCCUS ENTERICUS
• Secretion of succuss entericus is regulated by both
nervous and hormonal mechanism.
NERVOUS REGULATION
• Stimulation of parasympathetic nerves –
vasodilatation- increase secretion of succuss
entericus
• Stimulation of sympathetic nerves – vasoconstriction-
decrease secretion of succuss entericus
Local nerve reflex – when chyme is enters the intestine
,tactile stimulation cause the development of local
nerve reflexes, which stimulate the glands of intestine.
• HORMONAL REGULATION
üWhen chyme enters the intestine, intestinal
mucosa secretes enterocrinin,secretin and
cholecystokinin, which promotes the
secretion of succuss entericus by
stimulating the intestinal glands.
 APPLIED PHYSIOLOGY
• MALABSORPTION
§ It is the failure to absorb nutrients such as
proteins, carbohydrates ,fats and
vitamins.
§ Malabsorption affects growth and
development of the body
§ It also causes specific diseases
• MALABSORPTION SYNDROME
§ Condition characterised by failure of
digestion and absorption in small intestine
§ It is generally caused by crohns disease,
tropical sprue, steatorrhea and celiac
disease.
 CROHNS DISEASE/ENTERITIS
• Is an inflammatory bowel disease(IBD),
characterized by inflammation of small
intestine, the ileum. The inflammation causes
malabsorption and diarrhoea.
CAUSES
• Abnormalities of immune system
• The immune system react to virus or bacterium
resulting in the inflammation of the intestine.
FEATURES
• Malabsorption syndrome
• Weight loss
• Abdominal pain
• Diarrhoea
• Rectal bleeding, anemia and fever
• Delayed or stunted growth in children
 TROPICAL SPRUE
• Tropical sprue is a malabsorption syndrome,
affecting the residents of or the visitors to tropical
areas where the disease is epidemic
CAUSES
• Not known and it may be related to infected
organisms
FEATURES
• Indigestion
• Diarrhea
• Anorexia nervosa and weight loss
• Abdominal and muscle cramps
 CELIAC DISEASE
• Autoimmune disorder characterized by damage of
mucosa and atrophy of villi in small intestine
resulting in impaired digestion and absorption
• Also called gluten sensitive enteropathy, celiac
sprue and non-tropical sprue
CAUSES
• Caused by gluten
• It is a protein present in the wheat, oats, barley, rye
and other grains.
• Gluten is like a poison to individual with celiac
disease because it damage the intestine severely.
FEATURES
• Diarrhea
• Steatorrhea
• Abdominal pain
• Weight loss
• Irritability
• Depression
qSTEATORRHEA
• Deficiency of pancreatic lipase resulting in the
malabsorption of fat.
 BRUSH BORDER ENZYMES SMALL
INTESTINE
• Brush border enzymes are the digestive enzymes
located in the membrane of the brush
border(microvilli)on intestinal epithelial cells.
• Brush border constitute closely packed microvilli
• The brush borders of the intestinal lining are the
site of terminal carbohydrate digestion.
• Brush border greatly increases the surface area
available for the absorption of digested food.
•
•
• The brush border enzymes are;
• Aminopeptidases, which break down peptides
into amino acids.
• Maltase, which hydrolyses maltose into glucose
• sucrase, which hydrolyses sucrose into glucose
and fructose
• Lactase, which hydrolyses lactose into glucose
and galactose
the products of these enzymes are then
absorbed into the blood.
•