NVCC Bio 212

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Martinis Visual Anatomy and Physiology First
Edition Martini w Ober
Chapter 21Digestive System III Lecture 9
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Lecture Overview

• Liver
• Gall Bladder
• Small Intestine
• Large Intestine

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Liver Hepat(o)-
Round ligament is part of the falciform ligament
that divides the lobes remnant of fetal
umbilical vein.
Note that the vena cava does not enter the liver
it passes by
Figure from Martini, Anatomy Physiology,
Pearson Education, 2004
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Arterial Supply and Venous Drainage of Liver
Figure from Martini, Anatomy Physiology,
Prentice Hall, 2001
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Hepatic Lobule
Hepatic lobules are the functional units of the
liver (gt100,000)
Figure from Saladin, Anatomy Physiology,
McGraw Hill, 2007
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Paths of Blood and Bile in Hepatic Lobule
Livers role in digestion is production of bile
Sinusoid
Hepatic portal vein ? sinusoids ? central vein ?
hepatic veins ? inferior vena cava
Hepatic artery
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Liver Functions (over 200!)

• Three general categories of function
• 1) Metabolic regulation
• Interconversion of carbohydrates, lipids, amino
  acids
• Removal of wastes
• Vitamin and mineral metabolism
• Drug inactivation
• Storage of fats, glycogen, iron, vit A/B12/D/E/K
• 2) Hematological regulation
• Phagocytosis and antigen presentation ab removal
• Synthesis of plasma proteins
• Removal of circulating hormones
• Removal of worn-out RBCs (Kupffer cells)
• Removal or storage of toxins
• 3) Synthesis and secretion of bile (digestion)

Know items in red
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Some Specific Liver Functions

• produces glycogen from glucose
• breaks down glycogen into glucose
• converts noncarbohydrates to glucose
• oxidizes fatty acids
• synthesizes lipoproteins, phospholipids, and
  cholesterol
• converts carbohydrates and proteins into fats
• deaminates amino acids
• forms urea
• synthesizes plasma proteins
• converts some amino acids to other amino acids
• stores fat, glycogen, vitamins A,D, E, K, B12,
  and iron
• phagocytosis of worn out RBCs and foreign
  substances
• removes toxins from blood, e.g., alcohol

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Gallbladder Cyst(o)-
Figure from Martini, Anatomy Physiology,
Prentice Hall, 2001
Main function is to store and concentrate bile
between meals, and release bile under the
influence of CCK
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Composition of Bile (Chole-)
Yellowish-green liquid continually secreted by
hepatocytes

• water
• bile salts (bile acids)
• derived from cholesterol
• emulsification of fats (increases surface area
  for digestive enzymes)
• absorption of fatty acids, cholesterol, and
  fat-soluble vitamins
• 80 are recycled (reabsorbed and reused)
  enterohepatic circulation of bile
• 20 excreted in feces (disposes of excess
  cholesterol)
• bile pigments (bilirubin and biliverdin from
  breakdown of RBCs)
• electrolytes

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Regulation of Bile Release from GB

• fatty chyme entering duodenum stimulates the GB
  to release bile (via CCK)

Secretin causes the bile ducts (and pancreatic
ducts) to secrete bile rich in HCO3-
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Actions of Cholecystokinin (CCK) on Digestion
Figure adapted from Barrett, K.,
Gastrointestinal Physiology, Lange, 2006
CCK
Contraction of Gallbladder
Secretion of pancreatic enzymes
Reduced emptying of stomach
Relaxation of hepatopancreatic sphincter
Protein, CHO, lipid absorption and
digestion Matching of nutrient delivery to
digestive and absorptive capability
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Three Parts of Small Intestine
Mixing bowl acid neutralization
Bulk of chemical digestion and nutrient
absorption occurs here
Main functions of small intestine 1) chemical
digestion 2) absorption of nutrients (90) from
chyme
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Blood Supply and Drainage of Small Intestine
Figure from Martini, Anatomy Physiology,
Prentice Hall, 2001
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Wall of Small Intestine
Plicae circulares permanent circular folds of
mucosa that further increase surface area for
absorption do not flatten out with distention
like rugae of stomach. Especially prominent in
lower duodenum and upper jejunum
Submucosa of duodenum contains mucus-secreting
glands (Brunners glands) that protect the small
intestine
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Intestinal Villi Glands
Figure from Saladin, Anatomy Physiology,
McGraw Hill, 2007
Intestinal glands secrete an abundant watery
fluid that helps absorb products of digestion.
They also contain enteroendocrine cells
(enterokinase, gastrin, secretin, CCK)
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Intestinal Epithelium
Microvilli further increase the surface area
available for absorption in the small
intestine Form a brush border on the
intestine Digestive enzymes are embedded in the
membrane of microvilli
Main function of plicae, villi, and microvilli is
to increase the surface area for absorption
(from about 3.6 ft2 to about 2200 ft2!)
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Secretions of Small Intestine

• peptidase breaks down peptides into amino
  acids
• sucrase, maltase, lactase break down
  disaccharides into monosaccharides
• intestinal lipase breaks down fats into fatty
  acids and glycerol
• enterokinase converts trypsinogen to trypsin
• gastrin/somatostatin hormones that
  stimulate/inhibit acid secretion by stomach
• cholecystokinin (CCK) hormone that inhibits
  gastric glands, stimulates pancreas to release
  enzymes in pancreatic juice, stimulates
  gallbladder to release bile, and relaxes
  hepatopancreatic sphincter (of Oddi)
• secretin stimulates pancreas to release
  bicarbonate ions in pancreatic juice stimulates
  gall bladder to release bicarbonate-rich bile

Brush border
See Table 17.9 in Hole for summary of digestive
enzymes
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Control of Intestinal Secretion and Absorption

• mucus secretion (protective) stimulated by
  presence of chyme in small intestine
• distension of intestinal wall activates nerve
  plexuses in wall of small intestine
• motility/secretion stimulated by gastroenteric
  reflex
• parasympathetics trigger release of intestinal
  enzymes

Figure from Martini, Anatomy Physiology,
Prentice Hall, 2001
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Movements of the Small Intestine
Movements in local segments can occur without
stimulation by parasympathetic NS. However,
nervous stimulation accelerates segmentation and
peristalsis.

• peristalsis pushing movements
• segmentation ringlike contractions that aid in
  mixing and slowing peristalsis
• overdistended or irritated wall triggers
  peristaltic rush resulting in diarrhea

Long distance movements are triggered by
stomach filling - gastroenteric reflex (?
motility and secretion along length of small
intestine) - gastroileal reflex (relaxation of
ileocecal sphincter)
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Absorption in the Small Intestine

• monosaccharides and amino acids
• through facilitated diffusion and active
  transport
• absorbed into blood

• electrolytes and water
• through diffusion, osmosis, and active transport
• absorbed into blood

• vitamins
• fat-soluble dissolve in dietary fats (vit
  A,D,E,K)
• Water-soluble through diffusion, except B12
  (active transport)
• Vitamin K (large intestine) with other lipids
• absorbed into blood

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Absorption of Fats in the Small Intestine

• fatty acids and glycerol
• several steps
• absorbed into lymph into blood

Chylomicrons contain TG, cholesterol, and
phospholipids
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Large Intestine
Figure from Martini, Anatomy Physiology,
Prentice Hall, 2001

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Histology of the Large Intestine
Walls of large intestine are much thinner than
the small intestine, however, the lumen is
larger Note lack of villi and presence of
numerous goblet cells (mucus) No enzymes
produced any digestion is from previously
introduced enzymes or bacteria

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Functions of Large Intestine

• little or no digestive function
• absorbs water, bile salts, and electrolytes
• secretes mucus (lubrication, binding,
  protection, pH)
• conversion of bilirubin (uro- and
  stercobilinogen)
• houses intestinal flora (800 species of
  bacteria) and absorbs vitamins liberated by
  bacterial action (K, B5, and Biotin) produces
  intestinal gas (flatus)
• forms and stores feces
• carries out defecation

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The Rectum, Anal Canal, and Anus
Temporary storage of fecal material in rectum
triggers the urge to defecate Internal anal
sphincter is usually contracted but relaxes in
response to distension. External sphincter must
be tensed to retain feces
Rectal valves
Procto- anus or rectum
(Keratinzed strat. squamous epithelium)
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Movements of Large Intestine

• slower and less frequent than those of small
  intestine
• mixing movements (haustral churning every 30
  min)
• mass movements - usually follow meals
  (stimulated by distension of stomach and
  duodenum)
• gastrocolic reflex
• duodenocolic reflex
• peristaltic wave from transverse colon through
  rest of large intestine

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All You Need to Know???
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Parasympathetic Defecation Reflex
Note that this reflex opens the internal
sphincter and closes the external sphincter Need
voluntary relaxation of the external sphincter
for defecation
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Feces

• water (75), solids (25)
• electrolytes
• mucus
• bacteria (30 of solids) and sloughed epithelial
  cells
• bile pigments altered by bacteria provide color
  (mainly urobilins and stercobilins)
• odor produced by bacterial compounds (indoles
  and skatoles, phenols, H2S, ammonia)
• indigestible materials

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Life-Span Changes

• teeth become sensitive
• gums recede
• teeth may loosen or fall out
• heartburn more frequent
• constipation more frequent
• nutrient absorption decreases
• accessory organs age but the effects are less
  noticeable

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Review

• Liver
• Two major lobes
• Blood supply and drainage
• Functional unit is the lobule
• Plates of hepatocytes
• Portal triads
• Blood/bile flow in lobules
• Three major categories of function
• Metabolic regulation
• Hematological regulation
• Bile production

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Review

• Gall Bladder (GB)
• Major function storage and concentration of
  bile
• Stimulated to contract by CCK
• Path of bile from GB
• Cystic duct
• Common bile duct
• Hepatopancreatic sphincter (Oddi) CCK relaxes
• Duodenal ampulla
• Bile
• Water, bile salts, bile pigments, electrolytes,
  cholesterol
• Function is emulsification of fats for digestion
• Absorption of fats

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Review

• Small Intestine
• Three major parts
• Duodenum mixing chamber mucus
• Jejunum digestion
• Ileum connects to cecum of large intestine
• Blood supply and drainage
• Suspended from the posterior abdominal wall by
  the mesentery
• Surface area greatly increased by
• Plicae
• Villi
• Microvilli

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Review

• Small Intestine (contd)
• Secretions
• Control of secretion and absorption
• Absorption
• Protein, CHO, electrolytes facilitated
  diffusion
• Fats via chylomicrons and lacteals -gt circulation
• Movements
• Local via myenteric plexuses
• Long distance via stomach filling
• Gastroenteric reflex
• Gastroileal reflex

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Review

• Large Intestine
• Three major parts
• Cecum (veriform appendix)
• Colon (ascending, transverse, descending)
• Rectum
• Blood supply and drainage
• Haustra (pouches)
• Longitudinal muscle of external muscularis
  reduced to long strips (taeniae coli)
• Wall is thinner than small intestine, less
  muscle, no villi

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Review

• Large Intestine (contd)
• Rectum
• Temporary storage of feces urge to defecate
• Internal sphincter contracted until distended
• External sphincter is voluntary
• Major Functions
• Absorption of water, bile salts, and electrolytes
• Absorbs vitamins produced by bacteria (K, biotin,
  B5)
• Converts bilirubin
• Movements slower and less frequent than small
  intestine
• Mass movements
• Stimulated by gastric and duodenal distension