OVERVIEW OF GIT FUNCTIONS & REGULATION 1 OBJECTIVES To know the components of GIT and their functional significance. Emphasize the functional importance of four layers of GIT. Outline four basic digestive processes. Recognize the importance of regulatory factors that controls digestive functions. 2 DIGESTIVE SYSTEM (GIT) Digestive Tract: Mouth Pharynx Esophagus Stomach Small intestine - Duodenum - Jejunum - Ileum Large intestine - Cecum - Appendix - Colon - Rectum Anus Accessory Digestive Organs: Salivary glands Exocrine pancreas Biliary system - Liver - Gall bladder 3 DIGESTIVE SYSTEM Digestive tract is 4.5 m (15 feet) in normal contractile state. Lumen is continuous from mouth to anus and hence is continuous with external environment. 4 DIGESTIVE SYSTEM Primary Function: Transfer nutrients, water, and electrolytes from ingested food into body’s internal environment. Food is ingested – digested – absorbed – distributed and used. The Digestive System Performs Four Functions: 1- Motility 2- Secretion 3- Digestion 4- Absorption 5 FUNCTIONS OF THE DIGESTIVE SYSTEM 1- Motility: Muscular contractions that mix and move forward the contents of the digestive tract. Two Types of Digestive Motility: Propulsive (peristaltic) movements Mixing (segmenting) movements 6 Types of Digestive Motility 1- Propulsive (= Peristaltic) Movements: Push contents forward through the digestive tract. Velocity with which contents are moved forward (rate of Propulsion) varies in different regions of GIT, depending on functions of that region. For example: * Rapid movements in esophagus. * Slow movements in Small intestine. 7 GIT Motility Movements of contents through most of digestive tract is accomplished by contraction of smooth muscles (involuntary component) except: 1- Mouth (chewing). 2- Early part of esophagus (swallowing). 3- External anal sphincter (defecation). In these regions, motility involves skeletal muscle (voluntary component). 8 Types of GIT Motility 2- Mixing (=segmenting) Movements: Serve Two Functions: 1- Mixing food with digestive juices & hence promotes digestion of foods. 2- Facilitates absorption by exposing all parts of intestinal contents to absorbing surfaces of digestive tract. 9 Segmentation Gut law: Distension of gut leads to peristaltic wave starting at the point of distension & proceeds anal wards. 10 FUNCTIONS OF THE DIGESTIVE SYSTEM 2- Secretions: Digestive juices are secreted in to GIT lumen by exocrine glands (through ducts). Digestive secretions consists of: 1- Water. 2- Electrolytes. 3- Specific organic constituents (enzymes, bile salts, or mucus) important in digestive process. 11 GIT SECRETIONS Secretions are released into the digestive tract lumen on appropriate neural or hormonal stimulation. Normally absorbed in one form or another into blood after their participation in digestion. Total quantity of fluid that is secreted from digestive glands into GIT lumen equals 7 liters / day. Failure of absorption of digestive juices, as in diarrhea & vomiting results in loss of fluid (dehydration). 12 13 FUNCTIONS OF THE DIGESTIVE SYSTEM 3- Digestion: Biochemical breakdown of structurally complex foodstuffs into smaller, absorbable units by enzymes produced within GIT. Complex food stuffs: i). Carbohydrate ii). Proteins iii). Fats These are large molecules, therefore, they are digested and then absorbed into the blood or lymph. 14 i). CARBOHYDRATES Carbohydrates are absorbed as monosaccharides e.g. glucose, fructose, and galactose. Cellulose is a polysaccharide found in plants. It can not be digested, therefore, works as bulk or ingestible fibers. ii). PROTEIN Proteins are absorbed as - Amino acids. - Small polypeptides. iii). FAT Fat are absorbed as - Monoglyceride [glycerol with one fatty acid]. - Free fatty acid. 15 FUNCTIONS OF THE DIGESTIVE SYSTEM 4- Absorption: In the small intestine, digestion is completed & most absorption occurs. The small intestine, with its epithelial folds, villi, and microvilli, has an internal surface area of 200 m2. Through process of digestion, small absorbable units resulting from digestion, along with water, vitamins, and electrolytes are transferred from digestive tract lumen into blood or lymph. Total quantity of fluid that must be absorbed: 2 L (ingested) + 7 L (secreted) = 9 liters / day. 16 DIGESTIVE TRACT WALL GIT wall has same general structure throughout length from esophagus to anus (with some local characteristic variations). Four major tissue layers: Mucosa (Innermost layer). Submucosa. Musculosa (Muscularis externa). Serosa (Outer layer). 17 Layers of Digestive Tract Wall 18 19 MUCOSA Lines luminal surface of digestive tract. Highly folded surface greatly increases absorptive area. Of Three layers: 1- Mucous membrane 2- Lamina propria 3- Muscularis mucosa 20 MUCOSA 1- Mucous Membrane: Inner epithelial layer serves as a protective surface. Modified in particular areas for secretion and absorption. Contains: Exocrine gland cells secrete digestive juices. Endocrine gland cells secrete blood-borne gastrointestinal hormones. Epithelial cells specialized for absorbing digestive nutrients. 21 MUCOSA 2- Lamina Propria: Middle layer of connective tissue on which epithelium rests. Houses gut-associated lymphoid tissue (GALT) Important in defense against disease-causing intestinal bacteria. 3- Muscularis Mucosa: Sparse layer of smooth muscle, contraction modifies the pattern of surface folding. 22 SUBMUCOSA Thick layer of connective tissue. Provides digestive tract with distensibility and elasticity. Contains larger blood and lymph vessels. Contains Submucosal nerve plexus or Meissners Secretion. plexus that regulates GIT 23 MUSCULOSA (= MUSCULARIS EXTERNA) Major smooth muscle coat of digestive tube. In most areas, it consists of two layers: 1- Circular layer (Inner layer): Contraction decreases diameter of lumen. 2- Longitudinal layer (Outer layer): Contraction shortens the tube. Together, contractile activity of these layers produces propulsive and mixing movements. Myenteric nerve plexus lies between the two muscle layers that controls Movements of GIT. 24 SEROSA Outer connective tissue covering of GIT. Secretes serous fluid (watery & slippery fluid) that Lubricates and prevents friction between digestive organs and surrounding viscera. Continuous with mesentery throughout much of the tract. This Attachment provides relative fixation and supports digestive organs in proper place while still allowing them freedom for mixing and propulsive movements. 25 REGULATION OF GIT FUNCTION Digestive motility and secretion are carefully regulated to optimize the digestion. Four factors are involved in regulating digestive system function: 1- Autonomous smooth muscle function. 2- Intrinsic local nerve plexuses. 3- Extrinsic autonomic nerves. 4- Gastrointestinal hormones. 26 1- AUTONOMOUS SMOOTH MUSCLE FUNCTION In the wall of GIT, some specialized smooth muscle cells are pacemakers cells known as interstitial cells of Cajal. These cells lie in between circular & longitudinal layer of smooth muscles. These are self-excitable cells that display rhythmic spontaneous variations in membrane potential known as slow wave potential or basic electrical rhythm (BER). 27 Autonomous Smooth Muscle Function 28 Slow Wave Potential If slow wave potential (slow depolarization) reaches threshold, action potentials are triggered resulting in rhythmic cycles of contraction. Reaching threshold depends on mechanical, neural and hormonal factors that influence starting point of slow wave potential (e.g. presence of food bolus in GIT). 29 Slow Wave Potential The rate of self-induced contractile activity depends on inherent rate established by involved pacemaker. The intensity of contractions depends on number of action potentials occurring at peak of slow wave. Greater the number of contraction, the higher the cytosolic calcium, the stronger the contraction. 30 2- INTRINSIC NERVE PLEXUSES Submucosal plexus and myentric plexus, together are often termed as Enteric nervous system. Primarily coordinate local activity in GIT. Intrinsic nerve plexuses can affect all functions of digestive tract, i.e. motility, secretion of digestive juices and gastrointestinal hormones. Intrinsic nerve plexuses activity can be influenced by endocrine, paracrine and nerve signals. 31 Submucosal nerve plexus or Meissners plexus that regulates GIT Secretion. Myenteric nerve plexus lies between the two muscle layers that controls Movements of GIT. 32 3- EXTRINSIC NERVES (AUTONOMIC) Both branches of ANS influence GIT motility & secretion either by: Modifying activity of intrinsic nerve plexuses. Altering level of GIT hormones secretion. Directly acting on smooth muscle and glands. Sympathetic inhibits the motility and secretion and parasympathetic increases both. Extrinsic nervous system coordinates activity between different regions of GIT. 33 Parasympathetic Sympathetic (Dominant) * Vagus supplies from the * Greater splanchnic nerve: esophagus till 1st half of large from LHCs of lower 8 Thoracic intestine. segments. * Lesser splanchnic nerve: * Sacral (S2, 3, 4) segments supply from LHCs of upper 2 Lumbar the rest of GIT till anal region. segments. 1. Contraction of GIT wall Relaxation of sphincters. & 1. Relaxation of GIT wall Contraction of sphincters. 2. Increase GIT secretions. 2. Decrease GIT secretions. 3. VD. 3. VC. 34 & GASTROINTESTINAL HORMONES Endocrine gland cells are tucked within mucosa of certain regions of GIT that release hormones into blood on appropriate stimulation. These hormones acts on other areas of GIT and exert either stimulatory or inhibitory influences on smooth muscle and exocrine cells. E.g. CCK, Secretin, Gastrin……………etc 35 Pathways Controlling GIT activities 36 GIT RECEPTORS & REFLEXES (i) Chemoreceptors: sensitive to chemical changes in lumen. (ii) Mechanoreceptors: sensitive to stretch on the wall. (iii) Osmoreceptors: sensitive to osmolarity of luminal contents. Stimulation of these receptors causes neural reflexes or secretion of hormones which effect motility and secretion of digestive juices. In GIT, two types of reflexes occur: 1. Short reflexes: local enteric reflex in wall of digestive tract. 2. Long reflexes: between CNS and Digestive system. 37 REFERENCES Human Physiology, Lauralee Sherwood, seventh edition. Text book Physiology by Guyton &Hall,11th edition. Text book of Physiology by Linda S. Contanzo, third edition. Physiology by Berne and Levy, sixth edition. 38 Thank you 39