Digestive

Name: ______________________________ System Module 12

Lec Section: __________ Date: __________

Clinical Case
An Unusual Transplant
Tayvian has been hospitalized for 2 weeks and is taking antibiotics for a stubborn case
of pneumonia. Now, although his cough has resolved, he has watery diarrhea (#7 on the
Bristol stool chart) 10 times a day. The last few times it was bloody. He has no appetite and
has crampy abdominal pain. He has a fever and is losing weight.
His doctor enters the room with the results of tests performed on his feces. “I am afraid
the normal, helpful bacteria that live in your colon have been killed off by the antibiotics that
cured your pneumonia. Now, harmful bacteria—Clostridium difficile—have taken over,”
reports the doctor. “They are producing toxins that are causing colitis (inflammation of the
colon). The usual treatment is more antibiotics.”
“Doctor,” admits Tayvian, “I don’t think I can take any more antibiotics. I feel worse
than when I came in here.”
The doctor replies, “Well, I have an idea: a transplant from one of your healthy, adult
grandchildren. It is a little unusual, so you need to keep an open mind.”
What kind of transplant can possibly help Tayvian?

Learning Outcomes
Organization of the Digestive System
1. Name the major and accessory organs of the digestive system.
2. Describe the functional histology of the digestive tract.
3. Describe the structural and functional features of smooth muscle tissue.
4. Explain the processes by which materials move through the digestive system.
Digestive Tract
5. Name the structure and primary functions of the digestive tract organs.
6. Describe the anatomy of the oral cavity, and discuss the function of its structure.
7. Describe the teeth, and differentiate between deciduous teeth and permanent teeth.
8. Describe the anatomy and functions of the pharynx and esophagus, and explain the
swallowing process.
9. Explain the embryonic development of the mesenteries, and describe the mesenteries that
remain in adulthood.
10. Describe the anatomy of the stomach and its histological features.
11. Describe the anatomy of the stomach relating to its role in digestion and absorption.
12. Describe the anatomy of the intestinal tract and its histological features.
13. Describe the anatomy and physiology of the small intestine.
14. Discus the major digestive hormones and their primary effects.
15. Explain the regulation of gastric activity by central and local mechanisms.
16. Describe the gross anatomy of the tree segments of the large intestine.
17. Describe the large intestine’s histology and role in fecal compaction, and explain the defecation
reflex.
Accessory Digestive Organs
18. Describe the functions of the accessory organs of the digestive system.
19. Discuss the structure and functions of the salivary glands.
20. Describe the anatomy and location of the liver and gallbladder.
21. Describe the histological features of liver tissue.
22. Describe the structure, functions, and regulatory activities of the gallbladder.
23. Describe the structure, functions, and regulatory activities of the pancreas.
24. Clinical Module: Breiefly describe several disgestive system disorders.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

FEW OF US THINK ABOUT OUR DIGESTIVE SYSTEM unless it malfunctions, yet each day
we spend conscious effort filling and emptying it. References to this system are part of our everyday
language. We may have a “gut feeling” or find an opinion “hard to swallow.”
A muscular tube called the digestive tract (or alimentary canal) and various accessory
organs make up the digestive system. The digestive tract includes the oral cavity (mouth), pharynx,
esophagus, stomach, small intestine, and large intestine. The accessory organs include the teeth,
tongue, and various glandular organs, such as the salivary glands, liver, gallbladder, and pancreas.
The accessory glandular organs secrete water, enzymes, buffers, and other components into ducts
that empty into the digestive tract. As food enters and passes
along the digestive tract, the secretions prepare nutrients for absorption across the digestive tract
epithelium. The digestive tract and accessory organs work together to perform the following functions:
o INGESTION: Ingestion occurs when foods and liquids enter the digestive tract via the mouth.
o MECHANICAL PROCESSING: Most ingested solids undergo mechanical processing by the
tongue and teeth before they are swallowed. Swirling, mixing, churning, and propulsive
motions of the digestive tract provide additional mechanical processing after swallowing.
o DIGESTION: Digestion is the chemical and enzymatic breakdown of complex sugars, lipids,
and proteins into small organic molecules that are absorbed by the digestive epithelium.
o SECRETION: Digestion involves the action of acids, enzymes, and buffers produced by active
secretion. Some of these secretions are produced by the lining of the digestive tract, but most
are produced and secreted by accessory organs, such as the pancreas.
o ABSORPTION. Absorption is the movement of organic molecules, electrolytes, vitamins, and
water across the digestive epithelium and into the interstitial fluid of the digestive tract.
o EXCRETION: Excretion is the elimination from the body of the undigested residue of food and
the waste products of metabolism. Waste products are secreted into the digestive tract,
primarily by the accessory glands, especially the liver.
o COMPACTION: Compaction is the progressive dehydration of undigested materials and
organic wastes prior to excretion from the body. The compacted material is called feces.
Defecation is the elimination of feces from the body through the anus.

The lining of the digestive tract plays an important defensive role by protecting the surrounding tissues
against
(1) The corrosive effects of digestive acids and enzymes,
(2) mechanical stresses, such as abrasion, and
(3) pathogens that are swallowed with food or reside within the digestive tract.

In summary, the organs of the digestive system mechanically and chemically process food that is
eaten and passed along the digestive tract. These activities reduce the solid, complex chemical
structures of food into small molecules. The epithelium lining the digestive tract absorbs these small
molecules for transfer to the circulating blood.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.1 The digestive system consists of the digestive tract and accessory organs

The digestive system consists of a muscular tube, the digestive tract,

also called the gastrointestinal (GI) tract or alimentary canal, and various
accessory organs. Food enters the mouth and passes along the length
of the digestive tract. On the way, accessory organs mechanically
process the food and produce secretions containing water, enzymes,
buffers, and other components that assist in preparing organic and
inorganic nutrients for absorption.

The digestive system works with

other systems to support tissues
that have no direct connection with
the outside environment and no
other means of obtaining nutrients.

The digestive tract begins at the oral cavity (mouth) and

continues through the pharynx (throat), esophagus,
stomach, small intestine, and large intestine (referred to as
the small bowel and large bowel), which opens to the
exterior at the anus. Accessory digestive organs include
the teeth, tongue, gallbladder, and glandular organs,
such as the salivary glands, liver, and pancreas.

1.1 Review:
A. Which other systems work with the digestive system to support the cells and tissues of the human body?
B. Starting at the mouth, identify the major organs of the digestive tract.
C. List the accessory organs of the digestive system.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.2 The digestive tract is a muscular tube lined by a mucous epithelium

The structure of the digestive tract varies to some degree from one region of the digestive tract to another. The
composite view shown in this module most closely resembles the small intestine, the longest segment of the
digestive tract.

The digestive tract is basically a long, muscular tube

lined by a mucous membrane. The lining often contains
permanent ridges as well as temporary folds that disappear as
the passageway fills. Together, the ridges and folds dramatically
increase the surface area available for absorption.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

Each layer in the wall of the

digestive tract has a different set
of functions. The mucosa has several
structural features that enhance its
ability to absorb nutrients from the
lumen of the tract. Those features are
shown in this diagrammatic view.

1.2 Review:
A. What is the importance of the mesenteries?
B. Name the four layers of the digestive tract beginning from the lumen of the digestive tract.
C. Compare the submucosal neural plexus with the myenteric plexus.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.3 Smooth muscle tissue is found throughout the body, but it plays a particularly
prominent role in the digestive tract

Smooth muscle tissue forms sheets, bundles, or sheaths around other tissues in almost every organ. Smooth
muscles around blood vessels regulate blood flow through vital organs. In the digestive and urinary systems,
smooth muscle sphincters regulate the movement of materials along internal passageways.

Smooth muscle cells are relatively long and slender, As with skeletal and cardiac muscle cells, actin and
ranging from 5 to 10 μm in diameter and 30 to myosin filaments are involved in smooth muscles
200 m in length. Wherever smooth muscle tissue forms contractions. However, the organization of those filament
layers, the cells are aligned parallel to differs from that of skeletal or cardiac muscle cells. a
one another. In the digestive tract, smooth muscle fiber has no T tubules, and the sarcoplas-
there is usually an inner circular mic reticulum that forms a loose network throughout the
layer and an outer longitudinal sarcoplasm. Smooth muscle cells also lack a myofibril
layer. In a longitudinal section of and sarcomeres. As a result, this tissue has no
digestive tract, no muscle striations, and is called nonstriated muscle.
cells in the circular layer of the
muscular layer look like little
round balls, whereas those
in the longitudinal layer
look like long spindles.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

Smooth muscle tissue can be divided into two subtypes based on distinctively different methods of
innervation and control.

Because the thick and thin filaments of smooth muscle are scattered and are not organized into
sarcomeres, tension development and resting length are not directly related. A stretched smooth
muscle soon adapts to its new length and retains the ability to contract on demand. This ability to
function over a wide range of lengths is called plasticity. Smooth muscle can contract over a range of
lengths four times greater than that of skeletal muscle. This is extremely important in the stomach,
intestines, urinary bladder, or uterus, which must undergo major changes in size and shape. These
smooth muscle tissues have a normal background level of activity known as smooth muscle tone.
Neural, hormonal, or local chemical factors can increase or decrease smooth muscle tone and alter
the degree of tension in the wall of a muscular organ.

1.3 Review:
A. Describe the orientation of smooth muscle fibers in the muscular layer of the digestive tract.
B. Identify the structural characteristics of smooth muscle fibers.
C. Why can smooth muscle contract over a wider range of resting lengths than skeletal
muscle?
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.4 Smooth muscle contractions produce motility of the digestive tract …

Coordinated contractions of smooth muscle within the muscular layer play a vital role in digestive tract
movement, or motility, by moving material along the digestive tract (peristalsis) and in mechanical
digestion (segmentation).
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

… and local factors interact with neural and hormonal mechanisms to regulate
digestive activities

Three major mechanisms regulate and control digestive activities. The primary stimuli involved
are local factors that may in turn activate neural or hormonal control mechanisms.

1.4 Review:
A. Which is more efficient in propelling intestinal contents along the digestive tract: peristalsis and
segmentation? Why?
B. Cite the major mechanisms that regulate and control digestive activities.
C. Describe enteroendocrine cells.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.5 The digestive tract begins with the mouth and ends with the anus

The digestive tract is a muscular tube approximately 10 m (33 ft) long. It can be divided into regions
that differ in histological structure and functional properties. In this section, we consider each of the
major organs of the digestive tract and their functions.

This table summarizes the general functions of the digestive tract.

The lining of the digestive tract also protects surrounding tissues against
digestive acids and enzymes, abrasion, and pathogens within the digestive tract.

1.5 Review:
A. Define ingestion.
B. Distinguish between chemical digestion and absorption.
C. Describe the function of the large intestine.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.6 The oral cavity is a space that contains the tongue, teeth, and gums

The oral cavity (mouth) is lined by the oral mucosa, which has a stratified squamous epithelium. A
layer of keratinized cells covers regions exposed to severe abrasion, such as the superior surface of
the tongue and the opposing surface of the hard palate. The epithelial lining of the cheeks, lips, and
inferior surface of the tongue is relatively thin and nonkeratinized. Nutrients are not absorbed in the
oral cavity, but digestion of carbohydrates and lipids begins here. The mucosa inferior to the tongue is
thin enough and vascular enough to allow rapid absorption of lipid-soluble drugs, such as nitroglycerin,
used to treat angina attacks.

This sagittal section introduces

the major structures forming the
boundaries of the oral cavity (mouth).
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

An anterior view of the oral cavity

shows additional details not visible
in the sagittal section.

1.6 Review and Integration:

A. The oral cavity is lined by which type of epithelium
B. Name the structure that forms the roof of the mouth
C. Describe the location of the fauces.
D. What effects might a shortened frenulum of the tongue cause?
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.7 Teeth in different regions of the jaws vary in size, shape, and function.
This is a sectional view through a representative adult tooth. The
bulk of each tooth consists of a mineralized matrix similar to that
of bone. This material, called dentin, differs from bone in that it does
not contain cells. Instead, cytoplasmic processes extend into the
dentin from cells making up the pulp in the central pulp cavity.

There are
four different
types of teeth,
each with a
distinctive shape
and root pattern.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.7 Review:
A. Name the three main parts of a typical tooth.
B. What is the name sometimes given to the third set of molars?
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.8 The muscular walls of the pharynx

and esophagus plays a key role
in swallowing

The pharynx, or throat, is an anatomical

space and a common passageway for
food, liquids, and air. Food passes through the oropharynx
and laryngopharynx on its way to the esophagus. This
illustration shows the major landmarks
and boundaries
of the pharynx.

The esophagus is a hollow muscular

tube approximately 25 cm (10 in.) long
and about 2 cm (0.80 in.)
in diameter at its widest
point. The primary
function of the
esophagus is to
actively move
food and liquids
to the stomach.

The layers of the esophageal wall are comparable with those in other
portions of the digestive tract. However, the shape of the lumen and
the structure of the muscular layer is unique to the esophagus. There is
no serosa, but an adventitia of connective tissue outside the muscular
layer anchors the esophagus to the posterior body wall.

This light micrograph illustrates the

extreme thickness of the epithelium
making up the esophageal mucosa layer.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

Swallowing, or deglutition, is a complex process that can be started voluntarily but proceeds automatically once it
begins. Although you take conscious control over swallowing when you eat or drink, swallowing is also controlled at the
subconscious level. Each day you swallow approximately 2400 times. We divide swallowing into three phases.

The esophagus begins posteriorly

to the cricoid cartilage. From this
point, where it is at its narrowest,
the esophagus descends toward
the thoracic cavity posterior to the
trachea. It passes inferiorly along the
posterior wall of the mediastinum
and enters the abdominopelvic
cavity through the esophageal
hiatus, an opening in
the diaphragm. The esophagus is
innervated by parasympathetic
and sympathetic fibers from the
esophageal plexus. Resting muscle
tone in the circular muscle layer in
the superior 3 cm of the esophagus
normally prevents air from entering
the esophagus. The band of smooth
muscle involved functions as an
upper esophageal sphincter. A
comparable area of smooth muscle
at the inferior end of the esophagus
forms the lower esophageal
sphincter (cardiac sphincter). It
normally remains in a state of active
contraction, preventing the backflow
of materials from the stomach into
the esophagus.

1.8 Review:
A. Name the regions and
functions of the pharynx.
B. Describe the
muscular layer of
the esophagus.
C. Describe the major event in
each of the three phases of
swallowing.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.9 The stomach and most of the intestinal tract are suspended by mesenteries and
covered by the peritoneum
The peritoneal cavity is a serous membrane that lines the abdominopelvic cavity, covering most of its organs. The
peritoneal cavity is a potential space between the parietal and visceral layers of the peritoneum. The visceral peritoneum
covers the organs and the parietal peritoneum lines the abdominal walls.

These diagrams are cross-sectional

views from early embryos. During
embryonic development, the digestive tract
and accessory organs are enclosed by the
peritoneal cavity and suspended by dorsal
and ventral mesenteries.

The diagrammatic cross-sectional view below and the

lateral view to the right show the mesenteries supporting
the digestive tract and accessory organs early in
development. The ventral mesentery later
disappears along most of the digestive tract,
remaining in adults in only two places: between
the stomach and the liver (the lesser omentum), and
between the liver and the anterior abdominal wall (the
falciform ligament).
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

As the digestive tract

elongates, the position
of the mesenteries changes.
Some segments of the tract
contact the posterior wall and
become fixed in position. As
the small intestine coils and
increases in length, segments
of the mesentery proper comes
into contact and fuse together.

A sagittal section reveals the orientation of the

mesenteries in an adult. The coils of the small
intestine are suspended by the mesentery proper. The
transverse colon and a small section near the end of the
large intestine are suspended by remnants of the original
mesocolon.

The serous membrane lining the peritoneal cavity continuously produces

peritoneal fluid, which provides essential lubrication. Because a thin
layer of peritoneal fluid covers the parietal and visceral surfaces, sliding
movements can occur without friction and resulting irritation. About 7
liters of fluid are secreted and reabsorbed each day, although the volume
within the peritoneal cavity at any one time is about 50 ml. Liver disease,
kidney disease, and heart failure can accelerate the rate at which fluids
move into the peritoneal cavity. The accumulation of peritoneal fluid
creates a characteristic abdominal swelling called ascites

1.9 Review:
A. What is the falciform ligament?
B. What is the function of the lesser omentum?
C. Explain the significance of peritoneal fluid.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.10 The stomach is a muscular, expandable, J-shaped organ with three layers in
the muscular layer

This illustration presents the major surfaces and regions of

the stomach. The shape is actually highly variable. When
empty, the stomach resembles a muscular tube with a narrow,
constricted lumen. When full, it can contain 1–1.5 liters of
material. That material, which consists of food combined with
saliva and the secretions of the gastric glands, is a viscous, highly
acidic, soupy mixture called chyme.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

This cadaver dissection

exposes the stomach
and greater omentum.

A partially sectioned and dissected

stomach reveals additional details
about the internal structure of this organ.

Review:
A. Name the four major regions
of the stomach in order from its
junction with the esophagus to
the small intestine.
B. What anatomical feature
of the stomach allows the
organ to form chyme?
C. Describe the lining
of the stomach.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.11 The stomach receives food and liquids from the esophagus and aids in
mechanical and chemical digestion
The stomach has four major functions:
(1) temporary storage of ingested food,
(2) mechanical digestion of ingested food,
(3) chemical digestion of food through
the action of acid and enzymes, and
(4) production of intrinsic factor.

The wall of the stomach is relatively thick

and muscular, and its mucosa has deep
folds that form gastric glands.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

Gastric glands in the fundus

and the body secretes most of the
acid and enzymes involved in the gastric
digestion. The gastric glands in
these areas are dominated by
parietal cells and chief cells.
Together, they secrete about 1500
mL (1.6 qt) of gastric juice each day.
Gastric glands in the pyloric part
secrete mucus and hormones
involved in the coordination and
control of digestive activity.

Parietal cells indirectly secrete hydrochloric acid (HCl) to keep the stomach contents
at pH 1.5–2.0. They do not produce this strong acid in the cytoplasm because it would
erode secretory vesicles and destroy the cell. Instead, H+ and Cl– are transported and secreted
independently, as diagrammed below. When gastric glands are actively secreting, enough
bicarbonate ions enter the bloodstream to increase the pH of the blood significantly. This
sudden influx of bicarbonate ions has been called the alkaline tide.

1.11 Review:
A. Explain the significance of the alkaline mucous layer lining the interior surface of the stomach.
B. What is the function of parietal cells?
C. Describe the alkaline tide.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.12 The intestinal tract is specialized to absorb nutrients

The intestinal lining has a series of transverse
folds called circular folds or plicae circulares.
Unlike the rugae in the stomach, these
circular folds are permanent features that do not
disappear when the small intestine fills. The small
intestine contains roughly 800 circular folds, most of
them within the jejunum. Their presence greatly
increases the surface area available for absorption.

The mucosa of the small intestine contains a series of fingerlike

projections, the intestinal villi. If the small intestine were a
simple tube with smooth walls, it would have a total absorptive area
of nearly 3300 cm2 (3.6 ft2). Instead, the mucosa contains circular folds,
which support a forest of villi. Each villus is covered by epithelial cells
whose exposed surfaces are covered with microvilli. This arrangement
increases the total area for absorption by a factor of more than 600, to
approximately 2 million cm2(more than 2200 ft2).

This diagrammatic sectional

view of the intestinal wall
shows features common to all
segments of the small intestine.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

Each villus has a complex internal structure. The The surface of each villus consists of a simple
lamina propria of each villus contains an extensive columnar epithelium that is carpeted with microvilli.
network of capillaries that originate in a vascular network Because the microvilli project from the epithelium, like
within the submucosa. These capillaries carry absorbed bristles on a brush, these cells are said to have a brush
to deliver nutrients to the hepatic portal system for border. Bruch border enzymes are integral membrane.
delivery to the liver, which adjusts the nutrient concentrations in blood proteins located on the surfaces of intestinal microvilli.
Before the blood reaches the general systemic circulation. T hese enzymes break down materials that come in contact
With the brush border. The epithelial cells then absorb the
Breakdown products.

Near the base of each intestinal gland, stem cells divide and produce
new generations of epithelial cells, which are continuously displaced
toward the intestinal surface. In a few days, the new cells reach the tip of a
villus and are shed into the intestinal lumen. This ongoing process renews
the epithelial surface. The disintegration of the shed cells adds enzymes to
the lumen. Paneth cells at the base of the intestinal glands have a role in
innate (nonspecific) immunity and
release defensins and lysozyme. These
secretions kill some bacteria and allow
others to live, thereby establishing the
microbiota of the intestinal lumen.

1.12 Review:
A. Name the layers of the small intestine from superficial to deep.
B. Describe the anatomy of the intestinal mucosa.
C. Explain the function of lacteals.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.13 The small intestine is divided into the duodenum, jejunum, and ileum

The small intestine, or small bowel, plays the key role in nutrient digestion and absorption. Ninety percent of
nutrient absorption occurs here; most of the rest occurs in the large intestine.

This diagram illustrates the distribution of the three segments

of the small intestine by the abdominopelvic region. The small
intestine fills much of the abdominopelvic cavity, and the mesentery
proper stabilizes its position. The small intestine averages 6 m (19.7
ft) long and has a diameter ranging from 4 cm (1.6 in.) at the stomach
to about 2.5 cm (1 in.) at its junction with the large intestine.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

Each segment of the small intestine has characteristic

features related to its primary functions.
The transition from one region to another is gradual,
and the boundaries are indistinct.

1.13 Review and Integration:

A. Name the three segments of the small intestine from
proximal to distal.
B. Identify the segment of the small intestine found within the
epigastric region.
C. What is the primary function of the duodenum?
D. A traumatic injury to the umbilical region could affect which
segments of the small intestine?
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.14 Several hormones regulate digestion

Several hormones that regulate digestion are produced by the
duodenum, which receives partially digested materials from the
stomach. The duodenum adjusts gastric activity and coordinates
accessory digestive organ secretion, depending on the composition of
the arriving chyme.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

This flowchart summarizes the pattern of hormone release

and the effects of those hormones within the digestive system.

1.14 Review and Integration:

A. Name the major hormones that regulate digestive activities.
B. How would the pH of the intestinal contents be affected if the small intestine did not produce
secretin?
C. Does a high-fat meal raise or lower the level of cholecystokinin (CCK) in the blood?
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.15 Central and local mechanisms coordinate gastric …

The duodenum plays a key role in controlling digestive function because it monitors the contents of the
chyme and adjusts the activities of the stomach and accessory glands to protect the delicate absorptive
surfaces of the jejunum. This pivotal role of the duodenum is apparent when you consider the three phases of
gastric secretion. The phases are named according to the location of the control center involved.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

… and intestinal activities

Two central reflexes are triggered by the

stimulation of stretch receptors in the
stomach wall as it fills. These reflexes accelerate
movement along the small intestine while
the enterogastric reflex controls the rate
of chyme entry into the duodenum.

In general, the rate of chyme movement into the small intestine

is fastest when the stomach is greatly distended and the meal
contains little protein. A big meal that contains small amounts
of protein, large amounts of carbohydrates, alcohol, or caffeine
will leave the stomach very quickly. One reason for this is that
both alcohol and caffeine stimulate gastric secretion and
motility.

1.15 Review and Integration:

A. Name and briefly describe an important characteristic of each of the three phases of gastric
secretion.
B. Describe two central reflexes triggered by stimulation of the stretch receptors in the stomach
wall.
C. Why might severing the branches of the vagus nerves that supply the stomach provide relief
for a person who suffers from chronic gastric ulcers (sores on the stomach lining)?
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.16 The large intestine stores and

concentrates fecal material

The horseshoe-shaped large intestine, also known as the

large bowel, has an average length of about 1.5 meters
(4.9 ft) and a diameter of 7.5 cm (3 in.). The major
functions of the large intestine include (1) reabsorbing
water and compacting the intestinal contents into feces,
(2) absorbing important vitamins generated by bacterial
action, and (3) storing fecal material prior to defecation.
The large intestine consists of three segments: the cecum,
the colon, and the rectum.

Material arriving from the ileum first

enters an expanded pouch called the
cecum. The cecum collects and
stores materials from the ileum and begins
the process of compaction
(the forming of feces by
compression).

The colon has a larger diameter and a thinner

wall than the small intestine. We can subdivide
the colon into four regions: the ascending colon,
transverse colon, descending colon, and sigmoid
colon. The ascending and descending colon are
retroperitoneal and firmly attached to the abdominal
wall. The transverse colon and sigmoid colon are
suspended by remnants of the embryonic mesocolon.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.16 Review:
A. Name the major functions of the large intestine.
B. Identify the four regions of the colon.
C. Describe mass movements.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.17 The large intestine compacts fecal

material; the defecation reflex coordinates
the elimination of feces
The major characteristics of the wall of the
large intestine are the lack of villi and the
presence of distinctive intestinal glands dominated
by mucin-secreting goblet cells. The mucosa of
the large intestine does not produce enzymes;
any digestion that occurs results from enzymes
introduced into the small intestine or from
bacterial action. The mucus lubricates the
feces as it becomes drier and more compact.

This illustration shows the characteristic features

of the rectum, the last segment of the digestive
tract. The lamina propria and submucosa of the distal
a portion of the rectum contains a network of veins.
If venous pressures there rise too high because of
straining during defecation or pregnancy, the
veins can become distended, producing
hemorrhoids.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

Less than 10 percent of the nutrient absorption within the digestive tract occurs in the large intestine. Nevertheless,
absorption in this segment of the digestive tract is very important. In addition to preventing dehydration by reabsorbing
water, the epithelium absorbs

The rectal chamber is

usually empty, except
when a powerful peristaltic
contraction forces feces out of
the sigmoid colon. Distension
of the rectal wall then starts
the defecation reflex, an
involuntary response to
stimuli in the large bowel that
results in a bowel movement.
This reflex involves two
positive feedback loops, a
short intrinsic myenteric
defecation reflex and a long
parasympathetic defecation
reflex, triggered by the
stimulation of stretch receptors
in the walls of the rectum.
In addition, other consciously
directed activities can
Increase intra-abdominal
pressures and help
force fecal material
out of the rectum.
These activities include the
Valsalva maneuver:
tensing the abdominal
muscles and elevating
intraabdominal pressures
by exhaling forcibly
with a closed glottis.

1.17 Review:
A. How does digestion occur in the large intestine?
B. Define hemorrhoids.
C. Describe the two positive feedback loops involved in the defecation reflex.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.18 Some accessory digestive organs have secretory functions

The accessory digestive organs with secretory functions

are the salivary glands, gallbladder, pancreas, and liver.
The salivary glands and pancreas produce and store
enzymes and buffers that are essential to normal
digestive function. In addition to their roles in
digestion, the salivary glands, liver, and pancreas
have vital metabolic and endocrine functions.

1.18 Review:
A. What is the function of the salivary glands?
B. Distinguish between the exocrine and endocrine secretions of the pancreas.
C. Which accessory organ of the digestive system is responsible for almost 200 known
functions?
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.19 Saliva lubricates, moistens, and protects the mouth and begins carbohydrate
digestion
Three major pairs of salivary glands secrete into the oral cavity. Each pair has a distinctive cellular organization
and produces saliva, a mixture of glandular secretions with slightly different properties. Any object in your mouth
can trigger a salivary reflex by stimulating receptors monitored by the trigeminal nerve (V) or taste buds
innervated by cranial nerves VII, IX, or X. Parasympathetic stimulation accelerates secretion by all the salivary
glands, resulting in the production of large amounts of saliva.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

Each submandibular gland contains

a mixture of secretory cells, some
specialized for mucous secretion and
Others specialized in enzyme production.

The saliva in the mouth is a clear, watery substance. About

70 percent originates in the submandibular glands, 25
percent from the parotid glands, and 5 percent from the sublingual
glands. Collectively, the salivary glands produce 1.0–1.5 L of
saliva each day, and 99.4 percent of that volume is water.
The remaining 0.6 percent includes electrolytes (mainly Na+, Cl-,
HCO3-), buffers, glycoproteins, antibodies, enzymes, and
wastes. Salivary mucin lubricates the oral cavity.
A continuous background level of saliva secretion flushes the
oral surfaces, helping keep them clean. Buffers in the saliva keep
the pH of your mouth near 7.0 and prevent the buildup of acids
produced by bacteria. In addition, saliva contains antibodies
(IgA) and lysozyme, which helps control populations of oral
bacteria. Food usually remains in the mouth long enough for
chewing (mastication) to mix it with saliva and break the
combination into a relatively homogeneous, pulpy mass.

1.19 Review and Integration:

A. Name the three pairs of salivary glands.
B. Damage to the parotid glands would affect the digestion of which nutrient?
C. Which pair of salivary glands contributes most to saliva production?
D. Which pair of salivary glands secretes substances that reduce oral bacterial populations?
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.20 The liver, the largest visceral organ, is divided into left, right, caudate, and
quadrate lobes

The liver, the largest visceral organ, is a firm, reddish brown

organ weighing about 1.5 kg (3.3 lb). These two horizontal
sections at vertebral levels T11 and T12 shown below give you an idea
of the size and position of the liver relative to other visceral organs.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

The major anatomical landmarks and

the four liver lobes are shown below.

1.20 Review:
A. Describe the outer covering of the liver.
B. What structure marks the division between the left lobe and right lobe of the liver?
C. Name the lobes of the liver.
D. What is the function of the gallbladder?
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.21 The gallbladder stores and concentrates bile

The gallbladder is a hollow, pear-shaped organ that stores and concentrates bile
prior to its ejection into the small intestine. This muscular sac is located in a recess in
the posterior surface of the liver’s right lobe. The gallbladder is divided into three
regions: the fundus, the body, and the neck.

In this view, the liver has been pulled

upward to show the gallbladder and
its associated ducts.

The bile duct passes within the lesser omentum

and penetrate the wall of the duodenum to meet
the pancreatic duct at the entrance to the duodenal
ampulla, a chamber within the duodenal papilla
that projects into the intestinal lumen.

1.21 Review:
A. Define emulsification.
B. Trace the drop of bile from
The hepatic ducts to the duodenal lumen.
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.22 The pancreas has vital endocrine

and exocrine functions
The pancreas lies posterior to the stomach, extending laterally from
the duodenum toward the spleen. The pancreas is a slender, pinkish
gray organ about 15 cm (6 in.) long and weighing about 80 g (3 oz).

The broad head of the pancreas lies within the loop formed by the
duodenum as it leaves the pyloric part. Like the duodenum, the
pancreas is retroperitoneal and bound to the posterior wall of
abdominal cavity.

The pancreas is primarily an exocrine

organ, and pancreatic tissue
is dominated by the pancreatic
acini, which produce digestive
enzymes and buffers.

Each day, the pancreas secretes about 1000 mL (1 qt) of pancreatic juice
containing a variety of enzymes and a watery buffer solution. This table
introduces the primary pancreatic enzymes produced.

1.22Review:
A. What is the primary digestive function of the pancreas?
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

1.24 Disorders of the digestive system are diverse and relatively common
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________
 Digestive
Name: ______________________________ System Module 12
Lec Section: __________ Date: __________

CLINICAL CASE WRAP-UP

An Unusual Transplant
Normally, the lining of the colon is lubricated with mucus and populated with millions of beneficial bacteria.
These “good” bacteria make up our normal colonic microbiome. They help us digest food and generate essential
vitamins.
When antibiotics kill these normal intestinal bacteria, other strains of bacteria can replace them. Often,
the replacing bacteria are harmful, producing toxins that irritate the intestinal lining and cause colitis. This is the
case with Clostridium difficile, or “C. diff.”
One treatment for stubborn C. difficile infections is a fecal microbiota transplant from a suitable donor,
often a relative. Feces from a healthy donor contain populations of good bacteria that usually colonize the large
intestine. With a minimal amount of processing, the donated feces are infused into the patient, often through a
nasogastric (NG) tube inserted into the nose and passed through the stomach into the duodenum. These normal
bacteria take up residence in the patient’s large intestine, crowd out the harmful C. difficile bacteria, and resume
their usual work of digestion and vitamin production.
Tayvian agreed to proceed with the fecal transplant. After the procedure, he recovered completely and
left the hospital.

1. If Tayvian’s Clostridium difficile colitis was not treated with a fecal transplant, what kind of health
problems might he continue to experience?
2. If you could look inside Tayvian’s large intestine with a colonoscope, what would you see?