Gastrointestinal tract is a continuous tube that consists of the mouth, pharynx, esophagus,

stomach, small intestine, large intestine, and anus.

The lumen of this tube is continuous with the external environment.
The accessory organs are the salivary glands, exocrine glands, and biliary system (liver and
gallbladder).

pharynx
Salivary gland

Upper larynx
esophygeal
sphincter
esophagus

liver Lower esophygeal

sphincter
duodenum stomach

Descending colon
cecum
rectum

anus
Functions of the digestive system

• This system has four functions:

1. Motility is the muscular contractions that mix and
move the contents forward of the digestive tract.
- propulsive movements
- mixing movements
2. Secretion is the transfer of digestive juices by
exocrine glands into the digestive tract.
3. Digestion is the chemical change (hydrolysis) of
large molecules (e.g., carbohydrates, proteins,
and fats) into their smaller subunits (e.g., starch
into glucose, proteins into amino acids, etc).
4. Absorption is the passage of the products of
digestion (e.g., glucose), along with water,
vitamins, and electrolytes, from gastrointestinal
lumen into the blood and lymph.
 Our diets contain mainly three types of food; Carbohydrates, fats, and proteins.
These large molecules must be broken down into smaller absorbable units by
process of digestion.
Carbohydrates monosaccharides
Proteins aminoacids
Fats fatty acids and monoglycerides
*** The process of digestion is done by digestive enzymes which add water
molecules to large molecules to break down them into smaller ones (Hydrolysis)

Glucose Glucose

Maltose

An example of hydrolysis. In this example, the disaccharide maltose (the

intermediate breakdown product of polysaccharides) is broken down into two
glucose molecules by the addition of H2O at the bond site.
Fig. 15-1, p. 466
 The wall of the digestive tract consists
.of four layers
• The mucosa lines the luminal surface. Its inner
epithelial layer has exocrine and endocrine
cells. The lamina propria is a middle layer of
connective tissue. The muscularis mucosa is a
sparse layer of smooth muscle.
• The submucosa is under the mucosa This
connective tissue has large blood and lymph
vessels. It contains a submucous plexus.
• The muscularis externa is the main smooth
layer of the digestive tube. It is between the
submucosa and outer serosa. The muscularis
externa has an inner circular layer and an outer
longitudinal layer. Their contractions produce
the propulsive and mixing movements.
• A myenteric plexus is between the two smooth
muscle layers.
Autonomous smooth muscle function

• Smooth muscle in GIT shows rhythmic

spontaneous variation in it’s resting BER
membrane potential (slow waves). It is
also called basic electric rhythm
(BER). They do not cause contraction
by themselves, but they bring smooth
muscle to their thershold and action
potentials occur and at that time
contraction developed.

*** Smooth muscle cells is connected to

the adjacent smooth muscle cells by
cap junction and electrical activity in
one muscle can pass through these
cap junction so the whole muscle
sheet acts as functional syncytium.

• This slow cyclic electrical activity is

originated from pacemaker cell called
Cajal cells which found between Muscle contraction
circular and longitudinal layers.
Digestive motility and secretion are regulated
.by four factors
1. Smooth muscle cells display rhythmic, spontaneous variations in membrane
potentials. This is autonomous smooth muscle function. The inherent rate
of several digestive processes (e.g., peristalsis and segmentation) depend
on pacesetter cells in the tract with this activity.
2. The enteric nervous system consists of myenteric plexus and submucous
plexus. Some neurons promote contraction of the smooth muscle of the
digestive tract or affect secretion of digestive juice, other neurons stimulate
secretion of GIT hormones
3. Extrinsic nerves of the autonomic nervous system innervate digestive
structures from the outside. They affect digestive tract motility and secretion
and modify the activity of enteric nervous system.
– Stimulation of parasympathetic system increases GIT motility and
secretion
– Stimulation of sympathetic system decreases GIT motility and secretion

4. Endocrine glands within the mucosa release hormones that have either
excitatory or inhibitory influences on smooth muscle and glands secretion
GIT receptors affect digestive activities
through neural and hormonal pathways
**Conditions or changes inside git are sensed by receptors
inside the tract.
***There are three types of such receptors;
chemoreceptors, mechanoreceptors, and osmoreceptors
*These receptors respond to changes in the digestive tract.
*Their activation produces short and long reflexes that
affect:
- smooth muscle (motility)
- exocrine glands (secretion of digestive juice)
- endocrine glands (secretion of local hormones)
 External Local changes in
influence digestive tract

Receptors in digestive tract

Extrinsic
Intrinsic Gastrointestinal
automatic
nerve plexuses hormones
nerves

Smooth muscle
Self-
(contraction for motility)
excitable
Exocrine gland cells
(secretion of digestive juices)
= Short reflex

= Long reflex Endocrine gland cells

(secretion of gastrointestinal
= Hormonal pathway and pancreatic hormones)
Fig. 15-3, p. 471
 Chewing
** is the first step in digestive process
** is can be voluntary or reflex (mostly) action.

** It’s functions
1. Grinds and breaks food up into smaller pieces
to facilitates swallowing
2. Mixes food with saliva
3. Stimulates taste buds by exposing them to
food
 :Salivary Glands
:The Major Salivary Glands

Parotid-produces serous secretion*

containing alpha amylase enzyme
(ptyalin)
Submandibular-produces serous and*
mucous secretion
Sublingual-similar to submandibular *
secretion

The Minor Salivary Glands-buccal glands*

secret only mucus

:Salivary Flow
L/day 1-2*
Salivary flow ranges between 0.5**
ml/min during basal flow and
5ml/min during maximum flow
 Basic saliva components

Water 99.5% •
– Ions: Na , K , Ca , Cl , HCO •
+ + 2+ –
3

:Proline-rich proteins for protection of teeth enamel •

• Enzymes: ptyalin (from salivary glands),
**lingual lipase (secreted from glands on the tongue).
• Immunoglobolins: IgA
• Mucin: glycoproteins for lubrication of food and
protection of oral mucosa
Lysozyme, lactoferrin, thiocyanate ions •
• pH of saliva is about 7
 Cerebral cortex Other inputs

Salivary center Conditioned

in medulla reflex

Pressure receptors Simple reflex Autonomic nerves

and chemoreceptors
in mouth

Salivary glands

Salivary secretions

Control of salivary secretion.

Fig. 15-4, p. 473
 Innervation of salivary glands

• Salivary secretion is continuous and

can be reflexly increased. A simple,
unconditioned salivary reflex is
coordinated by the salivary center in
the medulla. An acquired, or
conditioned, reflex occurs without oral
stimulation.
• Both branches of the autonomic
nervous system increase the rate of
stimulation.

Excitation of parasympathetic nerve fibers

(facial and glossopharyngeal nerves)
causes:
- Increased watery secretion rich in
enzymes
Excitation of sympathetic nerve fibers
(superior cervical ganglion) causes:
-slight increase in viscid saliva (rich in
mucus)
 Function of Saliva
 
1. Moistens oral mucosa. In fact, the mucin layer on the oral mucosa is
thought to be the most important nonimmune defense mechanism in the
oral cavity. It facilitates speaking and chewing.

2. Moistens dry food, lubricates food to facilitate swallowing and cools hot
food.
3. Provides a medium for dissolved foods to stimulate the taste buds.
4. Buffers oral cavity contents. Saliva has a high concentration of
bicarbonate ions.
5. Digestion. Alpha-amylase, contained in saliva, breaks down
polysaccharides into disaccharides, while lingual lipase helps break
down fats.
6. Neutralizes any gastric acid that refluxes from stomach
.into the lower esophagus
7. Mineralization of new teeth and repair of precarious enamel lesions.
Saliva is high in calcium and phosphate. It helps to minimize tooth decay
 Function of Saliva (cont.)
8. Protects the teeth by saliva protein which contains antibacterial
compounds. Thus, problems with the salivary glands generally result in
dental caries. 
9. Controls bacterial flora of the oral cavity
Lysozyme, Secretory IgA, and Salivary Peroxidase play important roles in
saliva’s antibacterial actions.
***Lysozyme agglutinates bacteria and activates autolysins.
IgA interferes with the adherence of microorganisms to host tissue. It***
neutralizes viruses, bacterial, and enzyme toxins
***Peroxidase breaks down salivary thiocyanate which, in turn, oxidizes the
enzymes involved in bacterial glycolysis.
Also saliva contains lactoferrin which binds free iron in the saliva causing ##
bactericidal or bacteriostatic effects on various microorganisms requiring
.iron for their survival

Some of intraoral complications of salivary hypofunction include

1. Candidiasis 
2. Recurrent aphthous ulcers 
3. Dental caries.
 Swallowing (deglutition)
• Is the second stage of food ingestion
• It consists of three stages
1. Voluntary stage- initiation stage
2. Pharyngeal stage Involuntary stages
3. Esophageal stage
 Bolus of
food

Tongue presses the

hard palate

Swallowing is initiated
forces the bolus by closing the
to oropharynx mouth and pushing
voluntarily the bolus
Tonsillar by the tongue
pillar posteriorly and
areas
upward against the
palate
 Reflexly
Nasopharynx
closed by
The second stage starts when elevation soft
the bolus reaches posterior part palate

of the mouth and early parts of

pharynx. It is involuntary action
and reflex in nature. Presence of
food in above places stimulates
pressure receptors there
specially on tonsillar pillars. Epiglottis closes
the larynx
Sensory impulses carried to
Bolus
swallowing center in brain stem. entering
esophagus
and UES
relax
 Pharyngeal stage (cont.)
• Impulses coming from swallowing center to
pharynx and esophagus to finish stage 2
and 3 of the swallowing act. In pharyngeal
stage, the following events occur:
1. pushing the soft palate upward to prevent
reflux of food to nasal cavity.
2. to prevent passage of food into trachea. This
done by:
a. The vocal cords are tightly closed
b. The larynx is elevated
c. Epiglottis swing back over the opening of
larynx.
3. Palatopharyngeal folds are pulled medially
forming slit through which the good
masticated food can pass easily.
4. Relaxation of upper esophageal sphincter
5. Pharyngeal muscle contraction starts
(peristalsis) from upper parts and
spreading down ward
 Pharyngeal stage (cont.)
• At the beginning of stage 2, inhibitory
impulses from swallowing center to
respiratory center to stop respiration.
• Pharyngeal stage lasts about 1 second.
• The upper esophageal sphincter (the
upper 3 cm of esophagus) is closed all the
time except during swallowing. It relaxes
during pharyngeal stage to allow the bolus
to pass into esophagus
 Esophageal stage )3(
• Movement of bolus through esophagus
is through peristalsists:
• Primary peristalsis is continuation of
pharyngeal peristalsis which takes 5-9
second to travel along the esophagus.
This peristalsis is capable to push the
bolus down ward.

• Secondary peristalsis starts if primary

peristalsis fails to push the bolus
downward and will continue until the
esophagus is empty. This peristalsis is
initiated by distention of the esophagus
by retained food. It is due to stimulation
of the myentric plexus in the wall of
esophagus.
Peristaltic contraction in esophagus
 Esophageal stage (cont.)
Lower esophageal sphincter
(LOS)
Is located 3 cm above the junction between
esophagus and stomach . It remains
contracted all the time except during
esophageal stage of swallowing.

*** LOS is important to prevent reflux of

stomach content into esophagus.

** failure of LOS contraction causes reflux

of stomach content to esophagus
When intra-abdominal pressure is
causing reflux esophagitis. increased during coughing, the
lower portion of the esophagus is
closed by valve like action of this
part
Bolus of food LOS opens
Due to wave
of relaxation
transmitted
through
Myenteric
Inhibitory
Neurons

Relaxed Relaxed
muscles muscles

Stomach Stomach
 VOMITING (EMESIS) ACT
The sudden and forceful expulsion of gastric and upper
intestinal contents
* It is controlled by neurons in medulla (the ‘vomiting
centre’)
*It is triggered by one or more of the following stimuli:
- excessive gastric or duodenal distension
- noxious substances in stomach
- certain smells or sights
- emotional factors
- touch receptors at back of throat
- reflexes involving semi-circular canals (‘motion
sickness’)
- stimulation of the ‘chemoreceptor trigger zone’ by
circulating ‘emetics’
VOMITING CENTER
**is found in reticular formation of medulla.
**receives sensory impulses from pharynx,
esophagus, stomach and upper parts of
small intestine.

CHEMORECEPTOR TRIGGER ZONE

** is located on the floor of fourth ventricle
of the brain.
** is stimulated by certain drugs, circulating
emetic substances.
** it is also stimulated by impulses coming
from vestibular apparatus.
 THE VOMITING REFLEX
SEQUENCE OF EVENTS

• It starts by salivation and sensation of nausea

• Deep inspiration
• Closure of glottis (to prevent passage of vomit into airways)
• Elevation of uvula (to prevent passage of vomit into nasal cavity).
• Relaxation of lower esophageal sphincter
• Contraction of diaphragm and abdominal muscles causes increased intra-
abdominal pressure.
• Rapid rise in intra-gastric pressure causes reverse expulsion of gastric
and upper parts of small intestine contents
***Vomiting act is accompanied by generalized autonomic effects e.g:
- sweating
- tachycardia
- Salivation
- Sensation of nausea
*** Vomiting of gastric content alone for prolonged time leads to metabolic
alkalosis