Anatomy & Physiology for Midwives 3: Third Edition

Chapter 1. Introduction to physiology

Learning objectives

• To describe the structure of a typical cell and the role of its organelles.

• To discuss how cell differentiation and organization permit physiological

function.

• To recognize the features and characteristics of different tissue types that

facilitate their function and characteristics.

• To describe the control of provision of oxygen and nutrients to cells and

how the waste products of metabolism are excreted.

• To identify key features of physiological control mechanisms.

• To describe the principles and components of a homeostatic system.

• To review the physiological systems involved in maintaining homeostasis.

• To be able to explain basic physiology to women so that they are able to

understand how pregnancy alters the way a woman's body functions in order
to support her pregnancy and prepare her physiologically for nurturing her
newborn infant.

Introduction

Physiology is the biological science which explores how living organisms are
able to function in order to survive and reproduce. Physiology investigates
the relationship between the structure and function of body systems. The
physiological systems are complex structures, which serve a particular
function such as blood circulation or respiration. Organs are made up of cells
organized into different tissue types such as nerve tissue or muscle tissue.
The physiological systems communicate and interact with each other. A key
concept of physiology is that life is only possible within some tightly
regulated conditions such as temperature and ion concentration.
Homeostasis describes an organism's ability to control its internal
environment and maintain a stable condition; this allows the organisms to
adjust to, and survive in, a broad range of environments. This book focuses
on human reproductive function. This chapter aims to provide an illustrated
introduction to, and an overview of, some of the basic physiological concepts
referred to and developed in subsequent chapters, with specific references to
reproduction. (For more details, readers are recommended to look at the list
of further reading at the end of the chapter.)

Chapter case study

Zara is a 29-year-old primipara who presents herself at the midwife's clinic,

which is held at her GP's surgery, giving a history of a positive pregnancy
test.
• If Zara had accessed pre-conceptual care what advice do you think she
should have been given in her preparation for pregnancy?

• What information would be available in Zara's medical records that would

be useful to the midwife in her initial assessment of Zara's pregnancy?

• How could this information be used by the midwife to inform Zara of the
physiological changes that have started to occur in her body?

The cell

The cell is the fundamental unit of structure and function of all living
organisms. The evolution of multicellular organisms has led to the
differentiation of cells, which means that different cells have evolved to
perform specific functions and processes that contribute to the well-being of
the organism as a whole. Differentiated cells form tissues, which combine
with other tissues to form organs, which are linked together in physiological
systems (Fig. 1.1). However, although cells can be highly specialized, they
all share common features of the single cellular organisms from which we
evolved. A typical human cell is about 10 μm in diameter. The largest human
cell is the oocyte (see Chapter 6); it can just be seen with the naked eye.
The follicular cells surrounding the oocyte have a more typical human cell
size. The sperm cell is one of the smallest human cells. Smaller cells and
organelles can be visualized by light and electron microscopy.

Fig. 1.1

Physiological systems: levels of organization of cells, tissues, organs and

physiological systems, using breast tissue as an example.
 Cell structure

Most cells contain cytoplasm and are bound by a plasma membrane. Within
them are various structures, called organelles (see Table 1.1), and a
specialized part of the cell, called the nucleus (Fig. 1.2). The fluid
surrounding the organelles is called cytosol.

Table 1.1 

Cell components
Cell
Structure Function
component
The cell membrane is composed
of a phospholipid bilayer
The membrane acts as a differential
Cell embedded with various protein
permeable membrane between the cell
membrane structures such as hormone
and its immediate environment
receptors, ion channels and
antigen markers
The nucleus contains deoxyribonucleic
acid (DNA), the genetic instruction for
The nucleus is bound by a the organism. Most of the time, the
membrane, similar to the plasma DNA is organized as chromatin threads;
membrane of the cell; this these condense into chromosomes prior
The nucleus contains openings referred to as to cell division. The nucleus stores and
nuclear pores, which allow the replicates DNA, which is expressed to
movement of substances in and synthesize proteins via a second type of
out of the nucleus nucleic acid, ribonucleic acid (RNA).
These proteins determine the structure
and function of the cell
This is a system of membranes,
enclosing a space, which is
RER appears rough because of the
continuous with the nuclear
attached ribosomes. RER is involved in
Endoplasmic membrane. Endoplasmic
protein packaging. SER is involved in
reticulum reticulum (ER) exists as rough
lipid and steroid synthesis and the
(granular) endoplasmic reticulum
regulation of intracellular calcium levels
(RER) and smooth (agranular)
endoplasmic reticulum (SER)
Chemical processes involved in the
formation of adenosine triphosphate
(ATP). The cristae (inner membrane
Spherical or elongated rod-like
folds) are the site of oxidative
structures surrounded by a folded
phosphorylation and the electron
inner membrane and a smooth
transfer chain of aerobic respiration.
Mitochondria outer membrane. There are more
Krebs (tricarboxylic acid or TCA) cycle
mitochondria in cells that are
and the oxidation of fatty acids take
metabolically active and have a
place within the matrix. Mitochondria
high energy requirement
contain mitochondrial DNA, which is
maternally inherited and contains the
genes for mitochondrial proteins
Golgi
A series of flattened curved Modifies proteins from the RER and
apparatus
membranous sacs sorts them into secretory vesicles
(complex)
Enclose acidic fluid containing digestive
Spherical or oval organelles
Lysosomes enzymes which act as a ‘cellular
enclosed by a single membrane
stomach’ breaking down cellular debris
Destroy reactive oxygen species and
Peroxisomes Similar structure to lysosomes
protect cell
Involved in maintaining cell shape and
Cytoskeleton Filamentous network
motility
 Fig. 1.2

A typical cell.

Cells and tissues

Although about 200 types of cells with different structures can be identified within the body, cells can be
grouped together in functional categories (Table 1.2). The study of the physical characteristics of cells is
called histology (see Box 1.1). There are four types of tissue: epithelial tissue, muscle, connective tissue
and neural tissue.

Table 1.2 Functional classification of cells

Hormone-
Cell Epithelial Support Contractile Immune
Nerve cells Germ cells Blood cells secreting
group cells cells cells cells
cells

Circulating
Lining gut Fibrous
1. red cells Lymphoid
and blood support Islets,
Spermatozoa tissues,
Example vessels tissue, Muscle Brain thyroid
Ova nodes and
Covering cartilage, 2. white cells spleen adrenal
skin bone
3. platelets

Organize and 1. Oxygen

Barrier; Direct cell transport Indirect cell
maintain
Function absorption; Movement communicat Reproduction Defence communicati
body
secretion ion on
structure 2. Defence
 1. Proteins
bind oxygen
Release
Tightly Produce and
chemical Haploid (i.e. Recognize Secrete
bound interact with 2. Proteins
Special Contractile messengers half-normal and destroy chemical
together by extracellular destroy
features proteins directly on chromosome foreign messengers
cell matrix bacteria
to other number) material into blood
junctions material
cells
3. Blood
clotting

Box 1.1

Histology

The study of tissue structure is described as histology. The functions of

tissues are reflected in the microscopic structure of the cells of which the
tissue is composed. For example, cells that are metabolically active contain
many mitochondria, whereas cells that produce hormones or enzymes, for
instance, will contain a large proportion of ER. Specific tissues and cellular
structures are often identified by the application of various chemicals that
stain particular tissues. Histology is important in diagnosing cancer, as the
cancerous tissue often has histological characteristics different from those of
the tissue in which the cancer has developed. Malignant cancerous tumours
have highly differentiated cells, which means they often appear different
from the normal tissue cells from which they arose; they often have a
simpler structure and are usually prolific in their division rate. These cells are
less likely to adhere to neighbouring cells as normal cells do, so they are
shed into the circulatory system and carried to other parts of the body where
they seed more tumours (secondary tumours or metastases). Benign
tumours usually have undifferentiated cells, which may closely resemble the
cells of the tissue from which they arose and tend only to grow in the one
position. Although cancers in pregnancy are rare, many cancerous cells may
respond to oestrogen (sometimes referred to as oestrogen dependent);
therefore, cancer growth during pregnancy can be quite rapid.

Epithelial tissue

Epithelial cells line the internal and external surfaces of body organs (Fig.
1.3), forming the outer layer of the skin, the mucous membranes, the lining
of the lungs, gut, reproductive and urinary tracts, and also the endocrine
and exocrine glands. Epithelial cells are often ‘polarized’ and have different
characteristics on their apical (top) surface and their basal surface (which is
in contact with the basement membrane). Epithelial cells are relatively
undifferentiated and tend to undergo frequent mitotic divisions (see Chapter
7). This is because they are often exposed to wear and tear and so
replacement epithelial cells are generated from a basal layer where cell
division takes place. Epithelial cells form a barrier, which allows secretion
and absorption of substances from one compartment to another. The skin is
a specialized epithelial layer. The basal layer produces cells that are enriched
with the protein keratin. The outer layers of skin cells are dead and so lack
cytoplasm; it is these keratinized dead cells that provide the barrier function
of the skin. Epithelial cells are classified by shape (cuboidal or columnar) and
the number of layers. If there is a single layer of cells, the epithelium is
described as simple; if there is more than one layer of cells (such as skin), it
is stratified. Pseudostratified cells are a single layer of cells that appear to
consist of more than one layer. Glands are derived from epithelial tissue.
Fig. 1.3

Types of epithelial cell: (A) squamous epithelium provides a smooth lining of

blood vessels (endothelium, alveoli of lung and glomeruli of kidney); (B)
cuboidal epithelium is often found on absorptive surfaces such as in kidney
tubules; (C) columnar epithelium is often associated with secretory and
absorptive tissues and may have microvilli, as in the gut; it may also be
ciliated, as in the upper airways.

(Reproduced with permission from Brooker, 1998.)

Muscle tissue

Muscle cells contain contractile elements, so the cells can generate the
mechanical force required for movement of the body or substances within
the body (Fig. 1.4) or change shape and size. Muscle tissue is formed from
the mesodermal layer of the embryo (see Chapter 9). There are three types
of muscle tissue: skeletal, cardiac and smooth muscle. Skeletal muscle may
be attached to bones and controls movement of the skeleton. Skeletal
muscle can also be attached to the skin, for instance the muscles of the face
involved with expression. Contraction of skeletal muscle is usually under
voluntary or conscious control. Skeletal muscle is often described as
‘striated’ because of the striped appearance of the sarcomeres of the muscle
observed under the light microscope. Skeletal muscle fibres can be
subdivided into slow and fast twitch fibres. Fast twitch fibres contract more
strongly but they tire easily, whereas slow twitch fibres can contract for
prolonged periods.

Fig. 1.4

Muscle: (A) skeletal muscle; (B) smooth muscle; (C) cardiac muscle.

(Adapted with permission from Brooker, 1998.)

Cardiac muscle is only found in the heart; it has some structural similarity with skeletal
muscle. Smooth muscle and cardiac muscle are usually under involuntary control (meaning
there is no conscious awareness of the control). Smooth muscle surrounds many of the
‘tubes’ in the body, maintaining the function of several body systems. Smooth muscle cells
are linked by gap junctions, and muscle contraction is relatively slow. Blood pressure is
maintained by the contraction of a smooth muscle layer in the walls of the blood vessels. If
the smooth muscle constricts, described as ‘vasoconstriction’, the internal lumen of the
vessel will decrease and blood pressure will increase. ‘Vasodilatation’ is the opposite
condition: the smooth muscle relaxes and the lumen diameter increases, so blood pressure
falls. Organized synchronized waves of smooth muscle contraction, for instance in the gut,
renal system and uterine tubes, generate peristaltic waves; these produce unidirectional
movement of the contents within the lumen of the tube (Fig. 1.5).

Fig. 1.5

Peristaltic waves: peristalsis is achieved

through the interaction of both longitudinal
and circular smooth muscle fibres found in
vessels with patent lumen. The peristaltic
waves are responsible for (usually)
unidirectional movement of the contents
within the lumen.

(Reproduced with permission

from Brooker, 1998.)

Connective tissue

Connective tissue functions to connect, anchor and support body structures

(Fig. 1.6). Connective tissue cells often produce an extracellular matrix
composed of proteins in a ground substance of sugars, proteins and
minerals. Bone is a type of connective tissue, whereas collagen is an
example of an extracellular matrix. Adipose tissue is composed of specialized
cells that store fat for future energy requirements and have an endocrine
role. Adipose tissue also acts as an insulating layer to conserve body heat
loss and so contributes to the maintenance of the homeothermic status of
the organism. Fibrous tissue is an example of dense connective tissue. It is a
tough tissue that forms ligaments, tendons and protective membranes.

Fig. 1.6

Connective tissue: (A) adipose tissue; (B) fibrous tissue;

(C) compact bone.

(Reproduced with permission from Brooker, 1998.)

Neural tissue

Neurons are cells that are specialized to initiate and conduct electrical
signals (Fig. 1.7). Neurons require the presence of glial cells for nourishment
and support; glial cells are also involved in the propagation of the electrical
impulses in the neurons. As neurons are so highly specialized, they do not
usually undergo further mitotic divisions once developed. Therefore, in the
fetal and early neonatal period, the number of neurons produced far exceeds
the level required for normal neurological function. To survive and function,
neurons need regular stimulation. Throughout life, millions of neurons
become dysfunctional and die.

Fig. 1.7

Types of neuron: (A) bipolar; (B) unipolar;

(C) multipolar.

The structural organization of the body

The body's organization can be understood by considering each component

organ system separately (see below). However, these systems all work
together, as a whole. Together the systems provide nutrients and oxygen for
the cells and the excretion of waste products (Fig. 1.8). Movement is
controlled and the temperature is maintained. Survival until reproductive
function is completed has allowed the species to multiply. Cells are bathed in
extracellular fluid, which can be differentiated into the interstitial fluid
surrounding the tissue cells and the plasma within the blood vessels.

Fig. 1.8

Organization of the body.

Homeostasis

Homeostasis is the term used to

describe the processes of the various
physiological systems that maintain the
constancy of the internal environment.
Multicellular animals are able to
maintain an internal stability that is
essential for the optimal functioning of
all body systems, whereas simple
unicellular organisms tend to inhabit
stable environments or have adapted to overcome fluctuations in the
environment, for instance by forming spores during dry periods. Unicellular
organisms rely on basic nutrients being present in the environment to allow
cell growth and reproduction.

The evolution of multicellular organisms and the development of motility

meant that these animals were able to move within the environment to seek
out the conditions that suited them best and so optimize their ability to
reproduce. Mammals have developed homeostasis to a high degree. Motility,
together with the homeostatic challenge of counteracting fluctuations in the
external environment, places a huge energy burden upon these individuals.
This increased energy requirement is above the basal metabolic rate, which
is the rate of energy required to maintain essential functioning only.

Homeostasis can be considered to have three main components:

• chemostasis: the maintenance of electrolytes and pH balance

• haemostasis: the maintenance of an adequate circulatory system

facilitating the passage of nutrients and oxygen into and waste products out
of the organism

• thermostasis: the maintenance of a constant internal temperature.

Homeostasis is regulated by the nervous system, the endocrine system and

behavioural factors that are dependent on conscious or subconscious action
by the organism. A homeostatic control system requires monitoring a
variable, detecting changes and generating responses which will restore the
composition of the internal environment (Fig. 1.9). (This type of system,
involving a process called negative feedback, is dealt with in more detail
under Hormonal regulation in Chapter 3, p. 64.)

Fig. 1.9

The principles of homeostasis.

Thermoregulation

Temperature regulation is one example of

homeostasis (Fig. 1.10). Enzymes regulating
biochemical changes, and physiological and
metabolic functions, have optimal activity within
a narrow temperature range. Outside this
physiological temperature range, the protein
structure of the enzyme begins to denature, so
the configuration (shape) of the enzyme distorts,
which affects its functional activity. A warm-blooded (homeothermic) animal
is well prepared to react quickly and efficiently to changes within the
environment, unlike a cold-blooded (poikilothermic) animal, which depends
upon the ambient temperature of the environment.
 Fig. 1.10

Temperature
regulation: a
homeostatic
system in
operation.

The nervous
system

The nervous
system coordinates
body functions. It
monitors
physiological
processes by
processing input
from the senses, integrating them and initiating responses or motor output.
The nervous system is an organization of millions of neurons, or nerve cells,
and glial cells, which support and regulate the composition of the nervous
system. It is composed of the brain, the spinal cord (in the centre of the
vertebral column) and the neurons throughout the body. The skull and the
vertebral column protect the brain and the spinal cord. The brain and spinal
cord form the central nervous system (CNS) and the remainder is the
peripheral nervous system (Fig. 1.11). Neurons usually consist of a cell body
and dendrites (extensions) and an axon or nerve fibre, which carries
information from the cell body to or from the CNS. They are of different
sizes; some neurons have axon projections over 1 m in length. A nerve is a
collection of axons running alongside each other over the same distance. A
ganglion is a collection of cell bodies of neurons within the peripheral
nervous system. Ganglions are located in dorsal (back) or ventral (front)
branches of the spinal cord. The spinal cord and spinal nerves are organized
on a segmental basis; this corresponds to the embryonic origin of the
dermatomes (see Chapter 9). Cranial nerves carry information between the
brain and regions of the head. Neurons that carry information towards the
brain, entering the dorsal roots of the spinal cord, are sensory or afferent
neurons. Neurons carrying information from the CNS to the skeletal muscles,
and leaving the spinal cord at the ventral roots, are motor or efferent
neurons (Fig. 1.12). Neurons that carry information between a sensory
neuron and the CNS (or between the CNS and a motor neuron) are known
as interneurons.

Fig. 1.11

Organization of the nervous system.

Fig. 1.12

Afferent and efferent neurons.

The action potential

Neurons carry information or nerve impulses by changing the electrical

charge along their axon length so the transmembrane polarity changes
rapidly from negative to positive and back. This change in electrical charge is
termed an ‘action potential’. When the impulse reaches the axon, specific
channels known as ‘sodium gates’ open, allowing the movement of
extracellular sodium ions across the concentration gradient into the axon. As
the sodium ions carry a positive charge, the immediate local area around the
sodium gate inside of the axon becomes electrically positive compared with
the immediate area outside and so the membrane becomes temporarily
depolarized. At the height of the action potential (about 1 ms) the sodium
channels close and the membrane becomes leaky to potassium ions; these
move out of the axon down the electrochemical gradient. The result is
restoration of the membrane potential, described as ‘repolarization’. That
segment of the axon then enters a refractory period when no further action
potential can be produced. However, depolarization in one small segment of
the neuron leads to depolarization in the next segment; the rapid movement
of the altered electrical activity is therefore propagated along the length of
the neuron.

The action potential moves along the axon. The information detected at the
periphery triggers activity at the neuron receptor and the action potential
travels along the axon to the synapse, a junction with another neuron. There
is a gap between two neurons at the synapse. Information transmission
across this gap is by chemicals called neurotransmitters. These are released
from the first neuron, travel across the synapse and trigger an action
potential in the second neuron. The connection between a stimulating
neuron and a muscle is called a neuromuscular junction. Action potentials
move faster in axons of greater diameter, and if the axon is insulated by a
myelin sheath. Myelin sheaths surround the nerve for short lengths
punctuated by the nodes of Ranvier. Action potentials in myelinated nerves
are not propagated as waves but move by saltatory conduction whereby
they ‘hop’ along the nerve in a fast and efficient manner. Multiple sclerosis is
due to breakdown of the myelin sheath, limiting the normal conduction of
action potentials along nerves.

The somatic and autonomic nervous systems

The somatic nervous system controls muscles that change position. These
muscles are called skeletal or voluntary muscles as they are controlled
voluntarily, whereas smooth muscle and cardiac muscle are controlled
involuntarily by the autonomic nervous system (ANS). The ANS controls the
internal functions of the body such as circulation, respiration, digestion and
metabolism.

Traditionally, the ANS has been divided into the sympathetic and
parasympathetic systems (Table 1.3); these two branches of the ANS are
described as working in tandem, either synergistically or antagonistically.
The sympathetic nervous system controls the responses and provision of
energy required for stressful situations; it is often known as the fear–fight–
flight system. Effects of the sympathetic system include increased heart rate
and blood pressure, pupillary and bronchial dilation, increased skeletal
muscle blood flow (at the expense of blood flow to other tissues), increased
glycogenolysis and lipolysis to increase energy provision and other responses
that facilitate fight or escape and heightened awareness to threatening
situations. The sympathetic system operates in conjunction with the
endocrine system, facilitating the release of adrenaline, which augments the
manifesting fear–fight–flight reflexes. Conversely, the parasympathetic
branch of the ANS is more influential in periods of rest and inactivity and
favours rest, increased digestive activity and restoration. Effects of
parasympathetic nervous activity include increased blood flow to the gut and
skin, stimulated salivary gland secretion and peristalsis, and slowing of the
heart rate. In the ANS, two neurons carry information from the CNS to the
target organ; these are described as autonomic ganglia. There is a further
division of the ANS called the enteric nervous system, which affects smooth
muscle and secretion in the gut.

The brain

The brain is the centre of the nervous system; it is the most complex organ
and is not fully understood. The vertebrate brain develops from three
anterior bulges of the neural tube (see Chapter 9), which are the brain stem,
the cerebellum and the cerebrum. The brain stem is formed of the medulla
oblongata (which controls autonomic functions), the pons (which relays
information to and from the higher centres of the brain) and the midbrain
(which integrates sensory information). The brain stem is an evolutionarily
older structure which regulates essential automatic and integrative
functions; it is often called the ‘lower brain’ and is particularly important in
maintaining homeostasis, coordinating movement. The cerebellum
coordinates and error-checks motor activities and perceptual and cognitive
factors.

The most highly evolved structure of the brain is the cerebrum. The outer
layer of the brain is the grey matter of the cerebral cortex, which is divided
into the left and right hemisphere (Fig. 1.13). The fibres that connect these
hemispheres are the corpus callosum, the largest white matter structure.
Different regions of the cortex are associated with different functions; they
can be illustrated in a figure known as the ‘sensory homunculus’ (Fig. 1.14).
The reticular formation acts as a sensory filter and is concerned with states
of waking and alertness. The hypothalamus is involved in motivation and
regulation and integration of many metabolic and autonomic processes. The
hypothalamus controls body temperature, hunger and thirst, and circadian
cycles and links the nervous and endocrine systems. The cerebellum is
mainly concerned with coordination of movement and repetitive performance
of previously learned tasks.

Fig. 1.13

The brain: an overview of

some of the functional areas.

Fig. 1.14

The ‘homunculus’: a
representation of the (A) motor
and (B) sensory areas of the brain
illustrating the proportion of brain
tissue dedicated to these areas.

(Reproduced with permission

from Brooker, 1998.)
The digestive system

As animals grew larger, they could not rely upon obtaining nutrients through
diffusion and random contact with the environment; they became hunters
and grazers. As they evolved, they became able to feed intermittently. They
could do this because they had developed the ability to digest (break down)
large organic macromolecules into smaller molecules through the action of
digestive enzymes. They were able to store and digest food slowly.
Mechanisms for food storage, such as the deposition of fat within adipose
tissue, enabled periods of food shortage to be overcome. The ability to
synthesize new tissue with energy expenditure is termed anabolism. When
tissue is broken down there is a reverse process termed catabolism; this
usually results in the production of energy and waste products, which
require excretion.

The gastrointestinal tract, or gut, is a long tube that runs from mouth to
anus (Table 1.4) in which food is digested and absorbed, to extract energy
and nutrients; the remaining waste is expelled. Food enters the mouth; here
it is masticated (mechanically broken down, thus increasing its surface area)
and lubricated and enzymes are added before it is passed through the
oesophagus to the stomach. The stomach is a bag-like swollen structure
where the first major digestive processes occur. Hydrochloric acid secreted
into the stomach maintains a pH of about 2; this has an important role in
destroying microorganisms. There is some protein breakdown in the
stomach and the food is mixed well. The mixed food, or chyme, then moves
into the duodenum where most of the digestion and absorption take place.
Digestive enzymes and bicarbonate ions (which neutralize the acidic pH) are
produced from the pancreatic exocrine tissue and secreted into the
duodenum. Bile salt secretion is important for the digestion of fats. The
small intestine is a major site of absorption and has a very large surface
area provided by finger-like projections called villi (Fig. 1.15). Tiny
projections or microvilli on the surface of the individual epithelial cells
further increase the surface area. The net result is a surface area of about
300 m . The epithelial cells lining the absorptive surfaces of the
2

gastrointestinal system have membrane-bound enzymes, for further

digestion of the food molecules, and specific transport mechanisms for
absorbing different molecules into the bloodstream.

Table 1.4 The digestive system

Region of gastrointestinal system Main digestive events

• Taste

• Mechanical digestion (chewing, mastication)

Mouth
• Food moistened and lubricated, to facilitate passage down the esophagus

• Starch digestion (amylase)

• Peristalsis enables transfer of food bolus to stomach

Oesophagus
• Buccal amylase activity continues

Stomach • Stores, mixes, dissolves, releases food

• Hydrochloric acid (HCl)

– lowers pH to 2

– kills microbes

– denatures proteins
 – converts pepsinogen to pepsin

• Mucus: protects gastric lining

• Pepsin: protein digestion

• Enzyme production: digestion

Pancreas
• Bicarbonate: neutralizes pH

Liver • Bile production

Gall bladder • Bile concentration and coordinated release facilitating emulsification of fats

Small intestine • Digestion and absorption of most nutrients

• Passage of undigested matter

Large intestine • Absorption of water and vitamins

• Provides environment for commensal symbiotic bacteria

• Storage of undigested matter

Rectum
• Defecation

Fig. 1.15

Structure of the small intestinal villi: (A)

transverse section through the intestinal wall;
(B) a villus; (C) details of the epithelium.

(Reproduced with permission from Saffrey

and Stewart, 1997.)