The alimentary tract

Plan

The alimentary tract 1

Mouth and oral structures 2

Pharynx 4

Esophagus 5

Stomach 6

Small intestine 8

Large intestine 11

Rectum and anus 12

Liver 13

Biliary tract 14

Pancreas 14

General features of digestion and absorption 15

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The alimentary tract

The digestive system is a group of organs working together to convert food into energy and basic nutrients to feed the entire body. Food passes through a long tube inside the body known as the alimentary canal or the gastrointestinal tract (GI tract). The alimentary canal is made up of the oral cavity, pharynx, esophagus, stomach, small intestines, and large intestines. In addition to the alimentary canal, there are several important accessory organs that help your body to digest food.but do not have food pass through them. Accessory organs of the digestive system include the teeth, tongue, salivary glands, liver, gallbladder, and pancreas. To achieve the goal of providing energy and nutrients to the body, six major functions take place in the digestive system:

• Ingestion
• Secretion
• Mixing and movement
• Digestion
• Absorption
• Excretion

Mouth and oral structures

Little digestion of food actually takes place in the mouth. However, through the process of mastication, or chewing, food is prepared in the mouth for transport through the upper digestive tract into the stomach and small intestine, where the principal digestive processes take place. Chewing is the first mechanical process to which food is subjected. Movements of the lower jaw in chewing are brought about by the muscles of mastication (the masseter, the temporal, the medial and lateral pterygoids, and the buccinator). The sensitivity of the periodontal membrane that surrounds and supports the teeth, rather than the power of the muscles of mastication, determines the force of the bite.

Mastication is not essential for adequate digestion. Chewing does aid digestion, however, by reducing food to small particles and mixing it with the saliva secreted by the salivary glands. The saliva lubricates and moistens dry food, while chewing distributes the saliva throughout the food mass. The movement of the tongue against the hard palate and the cheeks helps to form a rounded mass, or bolus, of food.

The lips and cheeks

The lips, two fleshy folds that surround the mouth, are composed externally of skin and internally of mucous membrane, or mucosa. The mucosa is rich in mucus-secreting glands, which together with saliva ensure adequate lubrication for the purposes of speech and mastication.

The cheeks, the sides of the mouth, are continuous with the lips and have a similar structure. A distinct fat pad is found in the subcutaneous tissue (the tissue beneath the skin) of the cheek; this pad is especially large in infants and is known as the sucking pad. On the inner surface of each cheek, opposite the second upper molar tooth, is a slight elevation that marks the opening of the parotid duct, leading from the parotid salivary gland, which is located in front of the ear. Just behind this gland are four to five mucus-secreting glands, the ducts of which open opposite the last molar tooth.

The gums

The gums consist of mucous membranes connected by thick fibrous tissue to the membrane surrounding the bones of the jaw. The gum membrane rises to form a collar around the base of the crown (exposed portion) of each tooth. Rich in blood vessels, the gum tissues receive branches from the alveolar arteries; these vessels, called alveolar because of their relationship to the alveoli dentales, or tooth sockets, also supply the teeth and the spongy bone of the upper and lower jaws, in which the teeth are lodged.

The teeth

The teeth are hard, white structures found in the mouth. Usually used for mastication, the teeth of different vertebrate species are sometimes specialized. The teeth of snakes, for example, are very thin and sharp and usually curve backward; they function in capturing prey but not in chewing, because snakes swallow their food whole. The teeth of carnivorous mammals, such as cats and dogs, are more pointed than those of primates, including humans; the canines are long, and the premolars lack flat grinding surfaces, being more adapted to cutting and shearing (often the more posterior molars are lost). On the other hand, herbivores such as cows and horses have very large, flat premolars and molars with complex ridges and cusps; the canines are often totally absent. Sharp pointed teeth, poorly adapted for chewing, generally characterize meat eaters such as snakes, dogs, and cats; and broad, flat teeth, well adapted for chewing, characterize herbivores. The differences in the shapes of teeth are functional adaptations. Few animals can digest cellulose, yet the plant cells used as food by herbivores are enclosed in cellulose cell walls that must be broken down before the cell contents can be exposed to the action of digestive enzymes. By contrast, the animal cells in meat are not encased in nondigestible matter and can be acted upon directly by digestive enzymes. Consequently, chewing is not so essential for carnivores as it is for herbivores. Humans, who are omnivores (eaters of plants and animal tissue), have teeth that belong, functionally and structurally, somewhere between the extremes of specialization attained by the teeth of carnivores and herbivores.

Each tooth consists of a crown and one or more roots. The crown is the functional part of the tooth that is visible above the gum. The root is the unseen portion that supports and fastens the tooth in the jawbone. The shapes of the crowns and the roots vary in different parts of the mouth and from one animal to another. The teeth on one side of the jaw are essentially a mirror image of those located on the opposite side. The upper teeth differ from the lower and are complementary to them. Humans normally have two sets of teeth during their lifetime. The first set, known as the deciduous, milk, or primary dentition, is acquired gradually between the ages of six months and two years. As the jaws grow and expand, these teeth are replaced one by one by the teeth of the secondary set. There are five deciduous teeth and eight permanent teeth in each quarter of the mouth, resulting in a total of 32 permanent teeth to succeed the 20 deciduous ones.

The tongue

The tongue, a muscular organ located on the floor of the mouth, is an extremely mobile structure and is an important accessory organ in such motor functions as speech, chewing, and swallowing. In conjunction with the cheeks, it is able to guide and maintain food between the upper and lower teeth until mastication is complete. The motility of the tongue aids in creating a negative pressure within the oral cavity and thus enables infants to suckle. Especially important as a peripheral sense organ, the tongue contains groups of specialized epithelial cells, known as taste buds, that carry stimuli from the oral cavity to the central nervous system. Furthermore, the tongue’s glands produce some of the saliva necessary for swallowing.

The tongue consists of a mass of interwoven striated (striped) muscles interspersed with fat. The mucous membrane that covers the tongue varies in different regions. The tongue is attached to the lower jaw, the hyoid bone (a U-shaped bone between the lower jaw and the larynx), the skull, the soft palate, and the pharynx by its extrinsic muscles. It is bound to the floor of the mouth and to the epiglottis (a plate of cartilage that serves as a lid for the larynx) by folds of mucous membrane.

Salivary glands

Food is tasted and mixed with saliva that is secreted by several sets of glands. Besides the many minute glands that secrete saliva, there are three major pairs of salivary glands: the parotid, the submandibular, and the sublingual glands. The parotid glands, the largest of the pairs, are located at the side of the face, below and in front of each ear. The parotid glands are enclosed in sheaths that limit the extent of their swelling when inflamed, as in mumps. The submandibular glands, which are rounded in shape, lie near the inner side of the lower jawbone, in front of the sternomastoid muscle (the prominent muscle of the jaw). The sublingual glands lie directly under the mucous membrane covering the floor of the mouth beneath the tongue.

The salivary glands are of the type called racemose, from the Latin racemosus (“full of clusters”), because of the clusterlike arrangement of their secreting cells in rounded sacs, called acini, attached to freely branching systems of ducts. The walls of the acini surround a small central cavity known as an alveolus. In the walls of the acini are pyramidal secreting cells and some flat, star-shaped contractile cells called myoepithelial, or basket, cells. The latter cells are thought to contract, like the similar myoepithelial cells of the breast, which by their contraction expel milk from the milk ducts.

The secreting cells may be of the serous or the mucous type. The latter type secretes mucin, the chief constituent of mucus; the former, a watery fluid containing the enzyme amylase. The secreting cells of the parotid glands are of the serous type; those of the submandibular glands, of both serous and mucous types, with the serous cells outnumbering the mucous cells by four to one. The acini of the sublingual glands are composed primarily of mucous cells.

The salivary glands are controlled by the two divisions of the autonomic nervous system, the sympathetic and the parasympathetic. The parasympathetic nerve supply regulates secretion by the acinar cells and causes the blood vessels to dilate. Functions regulated by the sympathetic nerves include secretion by the acinar cells, constriction of blood vessels, and, presumably, contraction of the myoepithelial cells. Normally secretion of saliva is constant, regardless of the presence of food in the mouth. The amount of saliva secreted in 24 hours usually amounts to 1–1.5 litres. When something touches the gums, the tongue, or some region of the mouth lining, or when chewing occurs, the amount of saliva secreted increases. The stimulating substance need not be food—dry sand in the mouth or even moving the jaws and tongue when the mouth is empty increases the salivary flow. This coupling of direct stimulation to the oral mucosa with increased salivation is known as the unconditioned salivary reflex. When an individual learns that a particular sight, sound, smell, or other stimulus is regularly associated with food, that stimulus alone may suffice to stimulate increased salivary flow. This response is known as the conditioned salivary reflex.

Pharynx

The pharynx, or throat, is the passageway leading from the mouth and nose to the esophagus and larynx. The pharynx permits the passage of swallowed solids and liquids into the esophagus, or gullet, and conducts air to and from the trachea, or windpipe, during respiration. The pharynx also connects on either side with the cavity of the middle ear by way of the Eustachian tube and provides for equalization of air pressure on the eardrum membrane, which separates the cavity of the middle ear from the external ear canal. The pharynx has roughly the form of a flattened funnel. It is attached to the surrounding structures but is loose enough to permit gliding of the pharyngeal wall against them in the movements of swallowing. The principal muscles of the pharynx, involved in the mechanics of swallowing, are the three pharyngeal constrictors, which overlap each other slightly and form the primary musculature of the side and rear pharyngeal walls. There are three main divisions of the pharynx: the oral pharynx, the nasal pharynx, and the laryngeal pharynx. The latter two are airways, whereas the oral pharynx is shared by both the respiratory and digestive tracts. On either side of the opening between the mouth cavity and the oral pharynx is a palatine tonsil, so called because of its proximity to the palate. Each palatine tonsil is located between two vertical folds of mucous membrane called the glossopalatine arches. The nasal pharynx, above, is separated from the oral pharynx by the soft palate. Another pair of tonsils are located on the roof of the nasal pharynx. The pharyngeal tonsils, also known as the adenoids, are part of the body’s immune system. When the pharyngeal tonsils become grossly swollen (which occurs often during childhood) they occlude the airway. The laryngeal pharynx and the lower part of the oral pharynx are hidden by the root of the tongue. The first stage of deglutition, or swallowing, consists of passage of the bolus into the pharynx and is initiated voluntarily. The front part of the tongue is retracted and depressed, mastication ceases, respiration is inhibited, and the back portion of the tongue is elevated and retracted against the hard palate. This action, produced by the strong muscles of the tongue, forces the bolus from the mouth into the pharynx. Entry of the bolus into the nasal pharynx is prevented by the elevation of the soft palate against the posterior pharyngeal wall. As the bolus is forced into the pharynx, the larynx moves upward and forward under the base of the tongue. The superior pharyngeal constrictor muscles contract, initiating a rapid pharyngeal peristaltic, or squeezing, contraction that moves down the pharynx, propelling the bolus in front of it. The walls and structures of the lower pharynx are elevated to engulf the oncoming mass of food. The epiglottis, a lidlike covering that protects the entrance to the larynx, diverts the bolus to the pharynx. The cricopharyngeal muscle, or upper esophageal sphincter, which has kept the esophagus closed until this point, relaxes as the bolus approaches and allows it to enter the upper esophagus. The pharyngeal peristaltic contraction continues into the esophagus and becomes the primary esophageal peristaltic contraction.

Esophagus

The esophagus, which passes food from the pharynx to the stomach, is about 25 cm (10 inches) in length; the width varies from 1.5 to 2 cm (about 1 inch). The esophagus lies behind the trachea and heart and in front of the spinal column; it passes through the diaphragm before entering the stomach. The esophagus contains four layers—the mucosa, submucosa, muscularis, and tunica adventitia. The mucosa is made up of stratified squamous epithelium containing numerous mucous glands. The submucosa is a thick, loose fibrous layer connecting the mucosa to the muscularis. Together the mucosa and submucosa form long longitudinal folds, so that a cross section of the esophagus opening would be star-shaped. The muscularis is composed of an inner layer, in which the fibres are circular, and an outer layer of longitudinal fibres. Both muscle groups are wound around and along the alimentary tract, but the inner one has a very tight spiral, so that the windings are virtually circular, whereas the outer one has a very slowly unwinding spiral that is virtually longitudinal. The outer layer of the esophagus, the tunica adventitia, is composed of loose fibrous tissue that connects the esophagus with neighbouring structures. Except during the act of swallowing, the esophagus is normally empty, and its lumen, or channel, is essentially closed by the longitudinal folds of the mucosal and submucosal layers. The upper third of the esophagus is composed of striated (voluntary) muscle. The middle third is a mixture of striated and smooth (involuntary) muscle, and the lower third consists only of smooth muscle. The esophagus has two sphincters, circular muscles that act like drawstrings in closing channels. Both sphincters normally remain closed except during the act of swallowing. The upper esophageal sphincter is located at the level of the cricoid cartilage (a single ringlike cartilage forming the lower part of the larynx wall). This sphincter is called the cricopharyngeus muscle. The lower esophageal sphincter encircles the 3 to 4 cm of the esophagus that pass through an opening in the diaphragm called the diaphragmatic hiatus. The lower esophageal sphincter is maintained in tension at all times, except in response to a descending contraction wave, at which point it relaxes momentarily to allow the release of gas (belching) or vomiting. The lower esophageal sphincter has an important role, therefore, in protecting the esophagus from the reflux of gastric contents with changes in body position or with alterations of intragastric pressure. Transport through the esophagus is accomplished by the primary esophageal peristaltic contractions, which, as noted above, originate in the pharynx. These contractions are produced by an advancing peristaltic wave that creates a pressure gradient and sweeps the bolus ahead of it. Transport of material through the esophagus takes approximately 10 seconds. When the bolus arrives at the junction with the stomach, the lower esophageal sphincter relaxes and the bolus enters the stomach. If the bolus is too large, or if the peristaltic contraction is too weak, the bolus may become arrested in the middle or lower esophagus. When this occurs, secondary peristaltic contractions originate around the bolus in response to the local distension of the esophageal wall and propel the bolus into the stomach. When a liquid is swallowed, its transport through the esophagus depends somewhat on the position of the body and the effects of gravity. When swallowed in a horizontal or head-down position, liquids are handled in the same manner as solids, with the liquid moving immediately ahead of the advancing peristaltic contraction. (The high pressures and strong contractions of the esophageal peristaltic wave make it possible for animals with very long necks, such as the giraffe, to transport liquids through the esophagus for many feet.) When the body is in the upright position, however, liquids enter the esophagus and fall by gravity to the lower end; there they await the arrival of the peristaltic contraction and the opening of the lower esophageal sphincter (8 to 10 seconds) before being emptied into the stomach.

Stomach

Anatomy

The stomach receives ingested food and liquids from the esophagus and retains them for grinding and mixing with gastric juice so that food particles are smaller and more soluble. The main functions of the stomach are to commence the digestion of carbohydrates and proteins, to convert the meal into chyme, and to discharge the chyme into the small intestine periodically as the physical and chemical condition of the mixture is rendered suitable for the next phase of digestion. The stomach is located in the left upper part of the abdomen immediately below the diaphragm. In front of the stomach are the liver, part of the diaphragm, and the anterior abdominal wall. Behind it are the pancreas, the left kidney, the left adrenal gland, the spleen, and the colon. The stomach is more or less concave on its right side, convex on its left. The concave border is called the lesser curvature; the convex border, the greater curvature. When the stomach is empty, its mucosal lining is thrown into numerous longitudinal folds, known as rugae; these tend to disappear when the stomach is distended.

The cardia is the opening from the esophagus into the stomach. The uppermost part of the stomach, located above the entrance of the esophagus, is the fundus. The fundus adapts to the varying volume of ingested food by relaxing its muscular wall; it frequently contains a gas bubble, especially after a meal. The largest part of the stomach is known simply as the body; it serves primarily as a reservoir for ingested food and liquids. The antrum, the lowermost part of the stomach, is somewhat funnel-shaped, with its wide end joining the lower part of the body and its narrow end connecting with the pyloric canal, which empties into the duodenum (the upper division of the small intestine). The pyloric portion of the stomach (antrum plus pyloric canal) tends to curve to the right and slightly upward and backward and thus gives the stomach its J-shaped appearance. The pylorus, the narrowest portion of the stomach, is the outlet from the stomach into the duodenum. It is approximately 2 cm (almost 1 inch) in diameter and is surrounded by thick loops of smooth muscle.

The muscles of the stomach wall are arranged in three layers, or coats. The external coat, called the longitudinal muscle layer, is continuous with the longitudinal muscle coat of the esophagus. Longitudinal muscle fibres are divided at the cardia into two broad strips. The one on the right, the stronger, spreads out to cover the lesser curvature and the adjacent posterior and anterior walls of the stomach. Longitudinal fibres on the left radiate from the esophagus over the dome of the fundus to cover the greater curvature and continue on to the pylorus, where they join the longitudinal fibres coming down over the lesser curvature. The longitudinal layer continues on into the duodenum, forming the longitudinal muscle of the small intestine.

The middle, or circular muscular layer, the strongest of the three muscular layers, completely covers the stomach. The circular fibres of this coat are best developed in the lower portion of the stomach, particularly over the antrum and pylorus. At the pyloric end of the stomach, the circular muscle layer becomes greatly thickened to form the pyloric sphincter. This muscular ring is slightly separated from the circular muscle of the duodenum by connective tissue.

The innermost layer of smooth muscle, called the oblique muscular layer, is strongest in the region of the fundus and progressively weaker as it approaches the pylorus.

The stomach is capable of dilating to accommodate more than one litre (about one quart) of food or liquids without increasing pressure on the stomach. This receptive relaxation of the upper part of the stomach to accommodate a meal is partly due to a neural reflex that is triggered when hydrochloric acid comes into contact with the mucosa of the antrum, possibly through the release of the hormone known as vasoactive intestinal peptide. The distension of the body of the stomach by food activates a neural reflex that initiates the muscle activity of the antrum.

Gastric secretion

The gastric mucosa secretes 1.2 to 1.5 litres of gastric juice per day. Gastric juice renders food particles soluble, initiates digestion (particularly of proteins), and converts the gastric contents to a semiliquid mass called chyme, thus preparing it for further digestion in the small intestine. Gastric juice is a variable mixture of water, hydrochloric acid, electrolytes (sodium, potassium, calcium, phosphate, sulfate, and bicarbonate), and organic substances (mucus, pepsins, and protein). This juice is highly acidic because of its hydrochloric acid content, and it is rich in enzymes. As noted above, the stomach walls are protected from digestive juices by the membrane on the surface of the epithelial cells bordering the lumen of the stomach; this membrane is rich in lipoproteins, which are resistant to attack by acid. The gastric juice of some mammals (e.g., calves) contains the enzyme rennin, which clumps milk proteins and thus takes them out of solution and makes them more susceptible to the action of a proteolytic enzyme. The process of gastric secretion can be divided into three phases (cephalic, gastric, and intestinal) that depend upon the primary mechanisms that cause the gastric mucosa to secrete gastric juice. The phases of gastric secretion overlap, and there is an interrelation and some interdependence between the neural and humoral pathways. The cephalic phase of gastric secretion occurs in response to stimuli received by the senses—that is, taste, smell, sight, and sound. This phase of gastric secretion is entirely reflex in origin and is mediated by the vagus (10th cranial) nerve. Gastric juice is secreted in response to vagal stimulation, either directly by electrical impulses or indirectly by stimuli received through the senses. Ivan Petrovich Pavlov, the Russian physiologist, originally demonstrated this method of gastric secretion in a now-famous experiment with dogs. The gastric phase is mediated by the vagus nerve and by the release of gastrin. The acidity of the gastric contents after a meal is buffered by proteins so that overall it remains around pH3 (acidic) for approximately 90 minutes. Acid continues to be secreted during the gastric phase in response to distension and to the peptides and amino acids that are liberated from protein as digestion proceeds. The chemical action of free amino acids and peptides excites the liberation of gastrin from the antrum into the circulation. Thus, there are mechanical, chemical, and hormonal factors contributing to the gastric secretory response to eating. This phase continues until the food has left the stomach. The intestinal phase is not fully understood, because of a complex stimulatory and inhibitor process. Amino acids and small peptides that promote gastric acid secretion are infused into the circulation, however, at the same time chyme inhibits acid secretion. The secretion of gastric acid is an important inhibitor of gastrin release. If the pH of the antral contents falls below 2.5, gastrin is not released. Some of the hormones that are released from the small intestine by products of digestion (especially fat), in particular glucagon and secretin, also suppress acid secretion.