PHYSIOLOGY Chapter 6PHYSIOLOGY Chapter 6
Chunmei Xia, Ph.DDepartment of Physiology and [email protected] number:021-54237612-805
2014-04-21 1
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We require:
carbohydrates (mainly glucose)
proteins (essential amino acids)
fats (but Western diet fats too high)
vitamins
minerals
Nutrition
Carbohydrate 50%
Fat 35%
Protein 15%
Intake (normally 3000-6000kcal per day & depends on
Geography
Occupation
• The GI tract (gastrointestinal tract)
The muscular alimentary canal– Mouth– Pharynx– Esophagus– Stomach– Small intestine– Large intestine– Anus
• The accessory digestive organs
Supply secretions contributing to the breakdown of food– Teeth & tongue– Salivary glands– Gallbladder– Liver– Pancreas
Digestive System Organization
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1.Digestion of food and absorption of nutrients are accomplished in a long tube connected to the external world at both ends
2.Secretion and motility of “the tube” are major themes in understanding the gut.
Main function
The Digestive Process• Ingestion
– Taking in food through the mouth• Propulsion (movement of food)
– Swallowing– Peristalsis – propulsion by alternate
contraction &relaxation• Mechanical digestion
– Chewing– Churning in stomach– Mixing by segmentation
• Chemical digestion– By secreted enzymes: see later
• Absorption– Transport of digested end products into
blood and lymph in wall of canal • Defecation
– Elimination of indigestible substances from body as feces 2014-04-21 5
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Histology/organization of the Gut Wall
From esophagus to anus, GI tract has the same basic arrangement of tissues.
There are 4 layers that can be distinguished
• Mucosa
• Submucosa
• Muscularis
• Serosa
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Layers of Gut Wall
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I REGULATION OF GASTROINTESTINAL TRACT FUNCTIONS
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Cell Hormone Site
G Gastrin (G) autrumn, duodenum
I Cholecystokinin (CCK) duodenum、jejunum
S Secretin duodenum、jejunum
D Somatostatin (SS) Stamoch, duodenum, pancreas, colon
L Enteroglucagon Small intestine, colon
PP Pancreatic polrpeptide (PP)
pancreas
EC1 Substance P (SP) Stamoch, intestine
D1 VIP Stamoch, intestine, pancreas
P bombesin Antrum, duodenum
N neurotensin ileum
B insulin pancreas
A glucagon pancreas
K Gastric inhibitory polypeptide(GIP)
duodenum、jejunum
Endocrine Cell and gut hormoneEndocrine Cell and gut hormone
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Types of secretionTypes of secretion
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Function of GI hormones
1. Regulate the secretion and motility of GI tractGastrin HCl secretion, gastric empty
2. Trophic actionGastrin stomach and duodenum mucosa
3. Regulate the release of other hormonesGIP insulinSS gastrin
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CONTROL OF DIGESTIVE FUNCTIONSBY NERVOUS SYSTEM
1.Autonomic nervous system (ANS) is divided into
- Parasympathetic- Sympathetic
2.Enteric nervous system: ENS
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Innervation of the GI tract
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Intrinsic (or enteric) nervous systemIntrinsic (or enteric) nervous system
exextrinsic trinsic nervous systemnervous system
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1.The autonomic nervous systemSympathetic system:
Noradrenaline
Gut secretions (+)Spinal cord
Pons/medulla
Midbrain
Gut sphincters (-)
Pancreas (+)
ACTION
Rectum (+)defaecation
ACTION
Gut wall (+)
adrenaline
EFFECTSEFFECTS
Salivary glands (+)X IX
VII
Cranial nerves
Parasympathetic system: Acetylcholine (Ach)
β(+) salivary glands
α (+) gut blood β2 (-) vesselsβ1/2 (-) gut wall, α (+) sphincters
(+) secretionAdrenal medulla
Dr. Alzoghaibi 15
CONTROL OF DIGESTIVE FUNCTIONSBY NERVOUS SYSTEM
Parasympathetic Nerves:• Located in brain stem & sacral region
• Projection to the G.I. are preganglionic efferents
• Vagus & pelvic nerves
• Vagus nerves synapse with neurons of ENS in esophagus, stomach, small intestine, colon, gall bladder & pancreas
• Pelvic nerves synapse with ENS in large intestine
• Neurotransmitter is Ach
Dr. Alzoghaibi 16
CONTROL OF DIGESTIVE FUNCTIONSBY NERVOUS SYSTEM
Sympathetic nerves:• Located in thoracic & lumbar regions
• Neurotransmitter is NE
• NE increases sphincter tension
• Inactivate the motility
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Innervation of the GI tract
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Innervation of the GI tract2. Intrinsic (enteric) nerve plexuses
Located
in the submucosa (submucosal or Meissner’s plexus) and between circular and longitudinal muscle layers (myenteric or Auerbach’s plexus)
Control
Motility - Myenteric plexus
Secretion - Submucosal plexus
through release of neurotransmitters
Excitatory - Acetylcholine, Substance P
Inhibitory - VIP, nitric oxide
Excitatory - Acetylcholine
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The enteric nervous system
Deep muscular
plexus
Submucosal
artery
Muscularis mucosa
Submucosalplexus
MUCOSA
Myenteric plexus
Longitudinal muscle
Circular muscle
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Intrinsic (or enteric)Intrinsic (or enteric)nervous systemnervous system
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The enteric nervous system coordinates
digestion,
secretion
motility
to optimize nutrient absorption.
Its activity is modified by information
from the CNS
from local chemical and mechanical sensors.
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Gastrointestinal reflex
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II GASTROINTESTINAL SMOOTH
MUSCLE
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Musculature of the GI tractAll smooth muscle except:
Upper third oesophagus – striated
Middle third of oesophagus – mixed
External anal sphincter – striated
Areas of striated muscle are areas that are under conscious control
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General Functional characteristicsGeneral Functional characteristics1. Lower excitability, slower contraction
and relaxation
2. Higher extensibility
3. Tonic contraction
4. Autorhythmicity5. More sensitive to stretch, chemicals, cold and warm stimulation but not to electric stimulation
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Slow Waves & Action potentials are Forms of Electrical Activity in GI Muscles
1. Resting potential
2. Slow wave or basic electric rhythmThe smooth muscle membrane slowly depolarizes and repolarizes in a cyclic fashion
3. Action potential
4. Relationship to contraction
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Insert fig. 18.16
Cells and Electrical Events in the Muscularis
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Slow waves in GI smooth muscle
Dr. Alzoghaibi28
‐ Unknown cause‐ Responsible for triggering AP in G.I.‐ Interstitial cells of Cajal, ICCs (pacemaker)
Myenteric borderSubmucosa border
‐ Occur at different frequency stomach (3/min) small intestine (duodenum, 12‐18/min) ileum & colon (6‐10/min)
‐ May or may not accompanied by AP
Electrical activity and muscle contraction
Factors that depolarize the membrane:Stretching of the muscle AchParasympathetic stimulation Hormonal stimulation
Factors that hyperpolarize the membrane:Norepinephrine Sympathetic stimulation
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GI motilityThere are many types of contractions in different areas of the GI tract.
Some muscles contract and relax in seconds – Phasic Contractions
-Peristalsis and Segmentation
Some maintain contractions over minutes or hours –Tonic Contractions
-Sphincter
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III GASTRIC MOTILITY
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Major Function of Gastric Motility
To serve as a reservoir
To break food into small particles and
mix food with gastric secretions
To empty gastric contents into the duodenum at a controlled rate
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1. Anatomy and innervation of the Stomach
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Stomach AnatomyStomach Anatomy
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The stomach can be divided into three anatomic regions (A)
and two functional regions (B)
Gastric reservoirTonic contractions Gastric reservoirTonic contractions
Gastric pumpPhasic contractionsGastric pumpPhasic contractions
BBFundusFundus
CorpusCorpusAntrumAntrum
PylorusPylorus
AA
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OesophagusLower OesophagealSphincter Fundus
Body
Antrum
DuodenumPylorus
Functional Anatomy of StomachFundus
Body
Antrum
• Storage
• Storage• Mucus• HCl• Pepsinogen• Intrinsic factor
• Mixing/Grinding• Gastrin
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2. Responses to Gastric Filling –Receptive Relaxation
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Receptive relaxationDuring chewing and swallowing food, the stimulation of food to the receptors in mouth, pharynx, and esophagus reflexly causes the smooth muscle of the fundus and body of the stomach to relax,
This process allows the stomach to accommodate a large amounts of food and fluid.
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Inhibitoryvagal fibre(NANC-inhibition)
Nutrients
CCKRelaxation of
gastric reservoir
ACH
Vaguscentre
1. ReceptiverelaxationMechanical
stimuli in the pharynx
3. Feedbackrelaxation
2. Adap tiverelax ation
The relaxation of the gastric reservoir is mainly regulated by reflexes.
receptive, adaptive and feedback-relaxation
NutrientsTensionreceptors
Distension
NO + VIP et al.
Non Adrenergic Non Cholinergic)
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3. Peristalsis of the Gut and Gastric Emptying
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Gastric MotilityPeristaltic waves: Body → Antrum
BodyThin muscle → weak contraction→ No mixing
AntrumThick muscle → powerful contractionA Mixing
B Contraction of pyloric sphincter →
1 Only small quantity of gastric content (chyme) entering duodenum
2 Further mixing as antral contents forced back towards body
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Phase of propulsion Phase of retropulsionPhase of emptying
Bulge
Rapid flow of liquids withsuspended small particlesand delayed flow of large
Emptying of liquids withsmall particles whereaslarge particles are retained
Antrum
The contraction of the gastric pump three phases:A: phase of propulsion, B: phase of emptying,C: phase of retropulsion and grinding
Retropulsion of largeparticles and clearingof the terminal antrum
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Control of gastric motilityVagovagal reflex – fundal relaxation
Myenteric plexus – slow waves –contraction
Parasympathetic and Gastrin – increase contraction force and frequency
Sympathetic – decrease contraction force and frequency
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Gastric emptying1. Def.
The process by which the chyme is expelled from the stomach into the duodenum is called the gastric emptying.
2. Control1) stomach: stimulating factor, neuronal and hormonal
2) duodenum: inhibiting factor
entero-gastric reflex, hormones
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Control of Gastric emptying
Stimulating factors in stomach– Presence of food
– Gastrin
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Control of gastric emptyingControl of gastric emptying
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Inhibitory effects in duodenum and jejunum –through reflexes and hormonesInhibitory reflexes – direct – myenteric plexus
indirect – via extrinsic nerves
Neural reflexes stimulated by:Distension, irritation, acidity, high osmolarity, protein/fat
Fats and acids also stimulate release of humoral factors which reduce gastric emptying
Cholecystokinin (CCK), stimulated by fats
Secretin, stimulated by acids
Control of Gastric emptying
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Enterogastric ReflexRegulates the rate at which chyme leaves the stomach
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non-digestible spheres
“Quality” of food regulates gastric emptying
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4. Vomiting
• Emesis
• Stretching, toxins, alcohol, spicy foods, and drugs may stimulate this.
• Emetic Center of the Medulla
• Diaphragm and abdominal wall contract
• Cardiac sphincter relaxes.
• Soft palate rises
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IV MOTILITY OF THE SMALL INTESTINE
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Function of Intestinal Motility
(1)To mix chyme with digestive secretion
(2)To bring fresh chyme into contact with the absorptive surface of the microvili
(3)To propel chyme toward the colon
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1. Tonic contraction: the base of the other contractions2. Segmentation contractions
(1) def.When a portion of the small intestine becomes distended with chyme,the stretch of the intestinal wall elicits a rhythmical contraction and relaxation of localized circular muscles
spaced at intervals along the intestine, (2) function: mix the chyme with the digestive juice increase its exposure to the mucosal surface
Types of small intestinal movement
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3. Peristalsis: propels the small intestinal contents towards the large intestines peristaltic rush:initiated by the harmful stimulation
4. MMC (migrating motor complex): Occurs during fasting state
Types of small intestinal movement
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Segmentation: mix contents to promote digestion & absorption
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Peristalsis
• Distinctive pattern of smooth muscle contractions that propels foodstuffs distally through the esophagus and intestines
• Mediated by….
– Local, intrinsic nervous system
– Ex: peristalsis is not affect to any significant degree by vagotomy or sympathectomy
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Peristalsis: movement along the tract
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Peristalsis of the small intestine
http://medweb.bham.ac.uk/research/toescu/Teaching/OverviewGITY2.html
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Control of Intestinal Motility – Neuronal
Mixing – segmentationFrequency set by slow waves (12/minute duodunum)
additional control: myenteric plexus
Propulsion – peristalsisLocal reflex – stretch causes relaxation distal and
contraction proximal
Moves bolus through intestines
Intestino-intestinal reflex – extrinsic nerves
Local stretch in one area inhibits contraction in rest of bowel
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Gastrin Secretin
CCK + motility -- Glucagon
5-HT VIP
Motilin GIP
Control of Intestinal Motility – Hormonal
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Ileocecal Valve
• What it is– Opening to large intestines
• Function: • (1) prevent the repulsion • (2) control the emptying• normally closed. • Gastro-ileal reflex: enhances ileal emptying after eating. .
• The hormone gastrin relaxes ileocecal sphincter – Short-range peristalsis in
terminal ileum and distension relaxes IC sphincter
– small amount of chyme is squirted into the cecum.
• Distension of cecum contracts IC sphincter.
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V. GASTROINTESTINAL MOTILITY DURING FASTING STATE
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Gastric motility on fasting“Migrating Motor Complex, MMC”
•Occurs during fasting
•To clear undigested food particles
•Peristaltic contractions sweep down stomach and duodenum – pylorus relaxes
•Pattern of contraction approx. every 90 min
•Slow peristaltic waves sweeping whole of GI tract
•Thought to be controlled by motilin
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MMC(migrating motor complex)
• PhaseⅠ: Almost have no contractions 40-60 min• PhaseⅡ: have contractions, only have few 30-45 min• PhaseⅢ: have continuous contractions 5-10 min
• Originates simultaneously at the stomach and duodenum
• Migrates within 90 to 120 minutes along the small intestine
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Importance of MMC
1.Sweep the contents of the small intestine towards the colon
Housekeeper of the small intestine
2.Inhibit the migration of colonic bacteria into the terminal ileum
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VI MOTILITY OF THE COLON
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Large intestine
• Functions– Absorption of water and electrolytes– Storage of feces– In non-ruminant herbivores, fermentative digestion
and absorption of nutrients• Motility patterns
– mixing (form haustrations)– propulsive (mass movements)
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Segmentation in large intestine
• Haustration: (modified form of segmentation in which intense, local contraction of circular muscle causes large intestine to appear to bulge into sacs
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Mass movement
• Occurs in colon• Period of intense propulsive activity that
moves entire contents of colon distally toward rectum– Contractions progress for long distance such that
long length of colon contracts as a unit– Entry of fecal matter into recturn triggers
defecation reflex
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Mass Movement
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DefecationDefecation Reflex
initiated when rectal walls stretch⇓
parasympathetic reflex⇓
walls of the sigmoid colon and the rectum to contract & relaxation of
the anal sphincter⇓
External sphincter control is voluntary control
⇓If defecation is delayed: the reflex
stops until the next mass movement
PHYSIOLOGY Chapter 6PHYSIOLOGY Chapter 6
Chunmei Xia, Ph.DDepartment of Physiology and [email protected]
2014-04-21 1
Gastrointestinal Secretions and absorption
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Exocrine of the GI tractCompositionFunctionA. Digest foodB. Dilute the food into iso-
osmotic fluidC. Provide a favorable pH for
the digestive enzymesD. Provide mucus for
lubrication and protection of all parts of the alimentary tract
Regulation
Saliva 1.5 L/dpH 6.8-7.0Ingest 2
L/d water
Gastric secretion 2 L/d, pH 1.5-3
Bile 0.5 L/d pH 7.8-8.0
Pancreatic juice 1.5 L/d pH 8.0-8.4
Intestinal secretion 1.5 L/d pH 7.8-8.0
Small intestine absorbs 8.5 L/d
Colon absorbs 0.4-1 L/d
0.1 L/d water excreted
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1. Gastric secretion
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OesophagusLower OesophagealSphincter Fundus
Body
Antrum
DuodenumPylorus
Functional Anatomy of StomachFundus
Body
• Storage
• Storage• Mucus• HCl• Pepsinogen
Antrum
• Intrinsic factor
• Mixing/Grinding• Gastrin
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II.1 Gastric gland cells1. Oxyntic gland
Parietal cellChief cellMucous neck cell
2. Pyloric glandMucus cell
3. Cardiac glandMucus cell
4. Endocrine cells (G, D, ECL)
ECL:enterochromaffin-like cell
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Synthesize and secrete the HCl acid responsible for the acidic pH in the gastric lumen.
Synthesize and secrete the protease precursor known as pepsinogen.
Produce alkaline mucus that covers mucosa layer
Exocrine gland cells of gastric pits
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II.2 Composition and function of gastric secretions
1. HClconverts pepsinogen to pepsin for chemical digestion provides optimal pH environment for pepsindestroys some bacteriastimulates the small intestinal mucosa to release secretin and CCKpromotes the absorption of Ca2+ and Fe2+ in small intestine
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Composition and function of gastric secretions
2. Pepsinogen (precursor of pepsin)digestion of proteins
3. Mucusforms a protective barrier: Mucus-bicarbonate
barrier4. Intrinsic factor
combines with vitamin B12 to make it absorbable
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HCl secretion
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HCl secretion
pH<2pH>7.4
• H+ source is carbonic anhydrase H2O + CO2 ---> H2CO3
• H+ is pumped out via H+/K+
ATPase• Lots of mitochondria to generate
the ATP required• HCO3
- passes into the plasma in exchange for Cl-
• Cl- is secreted into the lumen
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Cells
Inactive precursor of pepsin which initiates protein digestion
Is not necessary for complete digestion of dietray protein –
pancretic enzymes are sufficient
Active only when the pH < 3.5
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Physical/chemical barrier to attack by gastric juice
Stimulated by:
• Ach
• Mechanical Stim
• Chemicals (ethanol)
If breached e.g. hypersecretion of acid -ulceration
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Gastric Mucus-Bicarbonate Barrier
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Gastric Mucus-bicarbonate barrier
The insoluble mucus and bicarbonate construct a barrier
prevent hydrogen ions from diffusing to the mucosal layerprotect the stomach mucosa from injury by hydrochloric acid and pepsin,
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Intrinsic Factor•Only gastric secretion that is essential for health
•Secreted from parietal cells in humans, cheif cells in other species
•Forms a complex with vitamin B12 in the gut
•The complex is resistant to digestion and therefore enables absorption of vitamin B12
•Lack of intrinsic factor causes Vit B12 deficiency (pernicious anaemia) – as all the Vit B12 is digested and therefore can not be absorbed
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Control of Gastric Acid SecretionGastric acid secretion is controlled by three
mechanisms:
• Neurocrine (vagus/local reflexes)• Endocrine (gastrin)• Paracrine (histamine)
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Endocrine gland cells of gastric pits
Stimulates acid secretion
Inhibits • acid secretion• gastrin and pepsin release• pancreatic exocrine secretions
Stimulates acid secretion
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Regulation of Gastric SecretionsThe important stimulatory signalsAutonomic nerves
• Release ACh• Stimulates smooth muscle contraction• stimulates Chief , Parietal , ECL and G cells
Gastrin• Stimulates Chief , Parietal , ECL cells
Histamin• Stimulates Parietal cells
Protein products such as peptidesStimulates G-cellsAcids
• Stimulate D cells
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Endogenous substances regulating gastric secretion
协同作用
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Gastric secretion during digesting food
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Gastric secretion in the digestive phaseGastric secretion in the digestive phaseCephalic phaseCephalic phase
Mechanisms:Mechanisms:Conditioned & Unconditioned reflexConditioned & Unconditioned reflexVagal efferent & with Gastrin secretionVagal efferent & with Gastrin secretion
through gastrinthrough gastrin--releasing peptide (GRP)releasing peptide (GRP)Experiment: Sham feeding by PavlovExperiment: Sham feeding by PavlovCharacteristics: Characteristics:
Large quantity (30%)Large quantity (30%)High acidity & digestive powerHigh acidity & digestive power
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Cephalic PhaseUnconditioned and conditioned reflex Only occurs when we want fooddepression dampens this reflexLarge amount of HCL and pepsinogen, high digestive
ability
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Experiment of Sham feeding by Experiment of Sham feeding by PavlovPavlov
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Cephalic Phase
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Mechanisms Stimulating Gastric Acid Secretion in Cephasic Phase
Sight, smell,taste of food
Vagusnerve
ParietalcellsACh
+
G cells Gastrin+
Gastrin/ACh ECLcells
Histamine
+GRP
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Gastric phaseGastric phaseMechanisms: Mechanisms:
•• Distension of gastric fundus & body Distension of gastric fundus & body initiating initiating vagovagal & local plexus reflexesvagovagal & local plexus reflexes
•• Distension of pylorus Distension of pylorus initiating a release of initiating a release of gastringastrin through intrinsic plexusthrough intrinsic plexus
•• Chemical stimulation Chemical stimulation of G cells initiating a of G cells initiating a release of gastrinrelease of gastrin
Characteristics: Characteristics: Large quantity (60%)Large quantity (60%)High acidity & digestive powerHigh acidity & digestive power 26
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Gastric phaseGastric phase
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Gastric Phase
Distensionof stomach
(arrival of food)
Vagal/Entericreflexes
Parietalcells
ACh
Peptidesin lumen
G cells Gastrin
Gastrin/ACh ECLcells
Histamine
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Intestinal phaseIntestinal phase
Mechanisms: Mechanisms: Mainly humoral regulationMainly humoral regulationChemical & Mechanical stimulationChemical & Mechanical stimulation
initiating releases of Gastrin, Enteroinitiating releases of Gastrin, Entero--oxyntin & Other humoral factorsoxyntin & Other humoral factors
Characteristics: Characteristics: Small quantity (10%)Small quantity (10%)Lower acidity & digestive powerLower acidity & digestive power
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Intestinal phaseIntestinal phase
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Regulation of Gastric Secretions occurs via 3 phases
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Hydrochloric acid (HCl)Hydrochloric acid (HCl)A typical example of negative feedbackA typical example of negative feedbackConditions & Mechanisms:Conditions & Mechanisms:
pH pH ≤≤ 1.2~1.5 in the gastric antrum1.2~1.5 in the gastric antrumInhibition of G cells, Release of SSTInhibition of G cells, Release of SST
pH pH ≤≤ 2.5 in the duodenum2.5 in the duodenumRelease of secretin, bulbogastroneRelease of secretin, bulbogastrone
Fat:Fat: Initiating release of enterogastroneInitiating release of enterogastroneHypertonic solutionHypertonic solution: Entero: Entero--gastric reflexgastric reflex
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Inhibitory regulation of gastric secretionInhibitory regulation of gastric secretion
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Enterogastrones
• Hormones released from gland cells in duodenal mucosa - secretin, cholecystokinin (CCK), GIP
• Released in response to acid, hypertonic solutions, fatty acids or monoglycerides in duodenum
• Act collectively to prevent further acid build up in duodenum
• Two strategies:• inhibit gastric acid secretion• reduce gastric emptying (inhibit motility/contract
pyloric sphincter)
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Regulation of gastric secretion
Secretion of Ach or other transmittersby nerve endings
Mechanical stimulationEntero-oxyntin
Fatty acids
Hyperosmotic solution
HCl
Gastric gland
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2. Secretion of the pancreas
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Secretion of the pancreas
Endocrine - insulin & glucagon
Exocrine - enzymes and bicarbonate
essential for digestion
almost under separate hormonal control
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Gall bladder
Sphincter of Oddi
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Cleave peptide bonds
Hydrolyze DNA/RNA
Collagen digestion
Phospholipids to fatty acids
Triglycerides to fatty acids+ glycerol
Starch to maltose + glucose
Categories of Pancreatic Enzymes
Proteases
Nucleases
Elastases
Phospholipases
Lipases
Amylase
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Activation of pancreatic proteases
Trypsinogen TrypsinEnterokinase
TrypsinogenChymotrypsinogen
ProelastaseProcarboxypeptidase
TrypsinChymotrypsin
ElastaseCarboxypeptidase
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** Regulation of pancreatic secretionRegulation of pancreatic secretionNervous regulationNervous regulation
Vagus nerve: ACh, gastrinVagus nerve: ACh, gastrinCharacteristics: HCharacteristics: H22O & HCOO & HCO33
−−↑↑, enzymes, enzymes↑↑↑↑Sympathetic nerve: ACh, NASympathetic nerve: ACh, NA
Characteristics: weak effectCharacteristics: weak effectHumoral reulationHumoral reulation
Secretin: HSecretin: H22O & HCOO & HCO33−−↑↑↑↑, enzymes, enzymes↑↑
Cholecystokinin (CCK): Cholecystokinin (CCK): Characteristics: HCharacteristics: H22O & HCOO & HCO33
−−↑↑, enzymes, enzymes↑↑↑↑Feedback:Feedback: CCKCCK--releasing peptidereleasing peptide
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3. Biliary secretion
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Structure/Function of LiverLiver lobule
Portal triad
Bilecanaliculus
Hepaticartery
Hepaticportal vein
Centralvein Central
vein
Portaltriad
BloodBile
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•• Bile secretion & gallbladder emptyingBile secretion & gallbladder emptying
** Nature, Compositions & functionsNature, Compositions & functions
Hepatic bile: pH 7.4, golden yellow Hepatic bile: pH 7.4, golden yellow
Bladder bile: pH 6.8, color become darkerBladder bile: pH 6.8, color become darker
Compositions: Compositions: HH22O, ions, bile acid, bile O, ions, bile acid, bile
pigment, fatty acid, cholesterol, lecithin, pigment, fatty acid, cholesterol, lecithin,
mucoprotein, etc., but no enzymemucoprotein, etc., but no enzyme
Functions of bile (mainly by bile salt): Functions of bile (mainly by bile salt):
Fat emulsificationFat emulsification; lipid absorption;; lipid absorption;
Promote the absorption of fatPromote the absorption of fat--soluble Vitssoluble Vits43
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** Control of bile secretion & gallbladder emptyingNervous regulation
Vagus nerve: ACh, gastrinHepatic bile secretion↑ (small amounts)Gallbladder contraction↑ (slightly)
Humoral reulationGastrin: direct to hepatic cells & gallbladder;
indirect to stomach→HCl→secretin →Secretin: act to bile duct & not to hepatic cells,
so: H2O & HCO3−↑, bile salt (−)
Cholecystokinin (CCK): gallbladder contraction & Oddi’s sphincter dialation
Bile salt: enterohepatic circulation of bile salt 44
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Digestion in the intestineDigestion in the intestine•• Pancreatic juice & its secretion Pancreatic juice & its secretion
** Nature, Compositions & functionsNature, Compositions & functionspH 7.8~8.4, colorless & odourless, 1~2 L/daypH 7.8~8.4, colorless & odourless, 1~2 L/dayBicarbonate (HCOBicarbonate (HCO33
−−))Neutralize HCl & provide a weak basic Neutralize HCl & provide a weak basic
medium favoring digestive enzyme actionmedium favoring digestive enzyme actionPancreatic enzymes: Pancreatic enzymes: amylase, lipase, colipase,amylase, lipase, colipase,
trypsinogen & chymtrypsinogen, etc.trypsinogen & chymtrypsinogen, etc.Turn trypsinogen into trypsin by enteroTurn trypsinogen into trypsin by entero--
kinase, turn chymtrypsinogen into chymkinase, turn chymtrypsinogen into chym--trypsin by trypsintrypsin by trypsin
Trypsin inhibitor: Trypsin inhibitor: a polypeptidea polypeptide46
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§§ 66. Absorption in the small intestine• Sites of absorption
Oral cavity & Stomach: littleDuodenum & Upper jejunum: most nutrientsIleum: bile salts & Vit. B12
Colon: water & electrolytes• Proofs as the main absorptive region
Huge absorptive surface (200 m2) Plenty of capillaries & lymph capillariesLarge quantity of digestive fluid (6~8 L/day)Food has almost completely been digested
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Enlargement of Enlargement of the surface the surface area of the area of the intestineintestine
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•• Absorption of main nutrientsAbsorption of main nutrients** WaterWater
8 L/day, passive & iso8 L/day, passive & iso--osmotic absorbedosmotic absorbedDifferent absorbability in different partsDifferent absorbability in different parts
** Inorganic slatsInorganic slatsSodium: 95%~99%, jejunum>ileum>colonSodium: 95%~99%, jejunum>ileum>colonactive transportactive transport
Ferrum: 1/10, mainly in duodenum & jejunum, Ferrum: 1/10, mainly in duodenum & jejunum, transferrin dependent, active transporttransferrin dependent, active transport
Calcium: promote by Vit. D, active transportCalcium: promote by Vit. D, active transportAnions: mainly Cl Anions: mainly Cl −− & HCO& HCO33
−−, passive transport , passive transport
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** CarbohydrateCarbohydrateAbsorptive form: monosarccharideAbsorptive form: monosarccharideMechanism: secondary active transportMechanism: secondary active transport
** ProteinProteinAbsorptive form: amino acidAbsorptive form: amino acidMechanism: secondary active transportMechanism: secondary active transport
** FatsFatsAbsorptive form: glycerol, monoglyceride, Absorptive form: glycerol, monoglyceride, fatty acid, cholesterolfatty acid, cholesterol
Mechanism: passive diffusionMechanism: passive diffusionPathway: blood & lymphPathway: blood & lymph
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Digestion & absorption of fats in the intestineDigestion & absorption of fats in the intestine
Digestive Homeostasis Disorders
• ULCERS – erosion of the surface of the alimentary canal generally associated with some kind of irritant
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•• CONSTIPATIONCONSTIPATION – a condition in which the large intestine is emptied with difficulty.
• Too much water is reabsorbed
• and the solid waste hardens
Digestive Homeostasis Disorders
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Digestive Homeostasis Disorders
• DIARRHEA – a gastrointestinal disturbance characterized by decreased water absorption and increased peristaltic activity of the large intestine.
• This results in increased, multiple, watery feces.
• This condition may result in severe dehydration, especially in infants
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Digestive Homeostasis Disorders
• APPENDICITIS – an inflammation of the appendix due to infection
• Common treatment is removal of the appendix via surgery
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Digestive Homeostasis Disorders
• GALLSTONES – an accumulation of hardened cholesterol and/or calcium deposits in the gallbladder
• Can either be “passed” (OUCH!!) or surgically removed
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Digestive Homeostasis Disorders
• HEART BURN – ACID from the stomach backs up into the esophagus.
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