Chapter 64: Secretory Functions of the Alimentary Tract Guyton and Hall, Textbook of Medical Physiology, 12th edition General Principles of GI Tract Secretion • Anatomical Types of Glands a. Mucous glands (Goblet cells) b. Crypts of Lieberkuhn c. Tubular glands d. Salivary glands, pancreas, and liver General Principles of GI Tract Secretion Fig. 64.1 Typical function of a glandular cell for formation and secretion of enzymes and other secretory substances General Principles of GI Tract Secretion • Basic Mechanism of Stimulation of the Alimentary Tract Glands 1. Contact of food with the epithelium stimulates secretion—function of enteric nervous stimuli 2. Local epithelial stimulation also activates the ENS and include tactile stimulation, chemical irritation, and distension of the gut wall General Principles of GI Tract Secretion • Autonomic Stimulation of Secretion 1. Parasympathetic stimulation increases alimentary tract glandular secretion; especially true in the upper portion of the tract. 2. Sympathetic stimulation has a dual effect; alone it slightly increases secretion, and if parasympathetic or hormonal stimulation is already causing copius secretion, the superimposed sympathetic will reduce the secretion General Principles of GI Tract Secretion • Autonomic Stimulation of Secretion 3. In the stomach and intestine, several GI hormones regulate the volume and character of the secretions. 4. The hormones are produced in response to food in the lumen of the gut General Principles of GI Tract Secretion • Basic Mechanism of Secretion by Glandular Cells 1. Secretion of organic substances (Fig. 64.1) 2. Water and electrolyte secretion 3. Lubricating and protecting properties of mucous Secretion of Saliva • Saliva Contains a Serous Secretion and a Mucus Secretion 1. Principle glands are the parotid, submandibular, and sublingual (also the tiny buccal glands) 2. Serous secretion contains ptyalin (amylase) and the mucus contains mucin for lubrication and surface protective properties Secretion of Saliva • Secretion of Ions in Saliva 1. Saliva contains large quantities of potassium and bicarbonate ions 2. Acini secrete a primary secretion containing ptyalin or mucin in a solution of ions 3. Ductal epithelium secretes the bicarbonate ion into the lumen Secretion of Saliva • Nervous Regulation of Salivary Secretion Fig. 64.3 Parasympathetic nervous regulation of salivary secretion Secretion of Saliva • Nervous Regulation of Salivary Secretion 1. Controlled mainly by parasympathetic pathways 2. Salivation can be stimulated or inhibited by signals coming from higher brain centers 3. Salivation can occur in response to reflexes in the stomach and upper small intestines 4. Sympathetic stimulation can increase salivation a small amount 5. Secretion always requires adequate nutrients from the blood Secretion of Saliva • Esophageal Secretion 1. Entirely mucus and provide lubrication for swallowing 2. Contains both simple and compound mucus glands Gastric Secretion • Characteristics of the Gastric Secretions 1. Secretions from the gastric glands (oxyntic) a) Mucus neck cells-secrete mucus b) Chief or peptic cells-secrete pepsinogen c) Parietal cells- secrete HCl and intrinsic factor Gastric Secretion Fig. 64.4 Oxyntic gland from the body of the stomach Gastric Secretion • Basic Mechanism of HCl Secretion Fig. 64.5 Schematic anatomy of the canaliculi in a parietao (oxyntic) cell Gastric Secretion Fig. 64.6 Postulated mechanism for secretion of HCl. “P” indicate active pumps and the dashed lines epresent free diffusion and osmosis Gastric Secretion • Basic Factors That Stimulate Gastric Secretion are AcH, Gastrin, and Histamine a. AcH (from parasympathetic stimulation) excites secretion of pepsinogen, HCl, and mucus b. Both gastrin and histamine stimulate secretion of acid by parietal cells but not the other cells Gastric Secretion • Secretion of Intrinsic Factor by Parietal Cells a. Essential for the absorption of vitamin B-12 in the ileum • Pyloric Glands—Secretion of Mucus and Gastrin • Surface Mucus Cells- secrete large quantities of viscous mucus that coat the stomach mucosa Gastric Secretion • Stimulation of Gastric Acid Secretions a. Parietal cells are the only cells that secrete HCl b. Paritetal cells operate in close association with enterochromaffin like cells (ECL) whose primary function is to release histamine c. Stimulation of acid secretion by gastrin-causes the release of histamine from the ECL cells; release of gastrin is in response to proteins in stomach Gastric Secretion • Stimulation of Gastric Acid Secretions d. Regulation of pepsinogen secretion occurs in response to two signals: 1) Stimulation of the peptic cells by AcH from the vagus nerve or nerves of the enteric nervous system 2) Stimulation of peptic cell secretion in response to acid in the stomach Gastric Secretion • Phases of Gastric Secretion a. Cephalic phase b. Gastric phase c. Intestinal phase Gastric Secretion • Phases of Gastric Secretion Fig. 64.7 Phases of gastric secretion and their regulation Gastric Secretion • Inhibition of Gastric Secretion by Other PostStomach Intestinal Factors a. Function is to slow passage of chyme from the stomach when the small intestine is already filled or overactive b. Presence of food initiates a reverse enterogastric reflex c. Presence of acid, fat, protein breakdown products, etc. causes the release of several intestinal hormones; especially secretin which inhibits stomach secretion Gastric Secretion • Chemical Composition of Gastrin and Other GI Hormones a. Gastrin, CCK, and secretin are all large polypeptides b. Activity of all of these lie in the last amino acids of the chain Pancreatic Secretions Fig. 64.10 Regulation of pancreatic secretion Pancreatic Secretions • Pancreas a. b. c. d. Large compound gland Enzymes secreted by the acini cells Bicarbonate secreted by small ductules Pancreatic juice produced in response to the presence of chyme Pancreatic Secretions • Pancreatic Digestive Enzymes a. For proteins: trypsin, chymotrypsin, and carboxypeptidase b. For cbh: pancreatic amylase c. For fats: pancreatic lipase, cholesterol esterase, and phopholipase Secretion of trypsin inhibitor prevents the digestion of the pancreas itself Pancreatic Secretions • Secretion of Bicarbonate Ions a. Bicarbonate provides alkali in the pancreatic juice to neutralize the HCl coming into the duodenum from the stomach Pancreatic Secretions Fig. 64.8 Secretion of isoosmotic sodium bicarbonate solution by the pancreatic ductules and ducts Pancreatic Secretions • Regulation of Pancreatic Secretion-Basic Stimulation That Causes Secretion a. Acetylcholine-released from the parasympathetic vagus nerve endings and other cholinergic nerves associated with the enteric nervous system b. Cholecystokinin-secreted by the duodenal and upper jejunal mucosa when food enters the small intestine c. Secretin-secreted as in cholecystokinin when highly acidic food enters the intestine d. Multiplicative effects of “a, b, and c” Pancreatic Secretions • Phases of Pancreatic Secretion a. b. c. d. Cephalic and Gastric Phases Intestinal Phase Secretin stimulates secretion of bicarbonate ions Cholecystokinin production which stimulates more digestive enzymes by the acini (similar to vagal stimulation) Secretion of Bile by the Liver • Functions of Bile a. Bile salts help to emulsify the large fat molecules of food and aid in the absorption of the digested fat b. Means of secretion of several important waste products from the blood (especially bilirubin and excesses of cholesterol) Secretion of Bile by the Liver • Physiologic Anatomy of Biliary Secretion a. Bile is secreted in two stages by the liver 1) Initial secretion by the hepatocytes; contains bile salts, cholesterol, and other organic compounds; into the bile canaliculi 2) Bile empties into termnal bile ducts, then the hepatic duct, and finally the common bile duct into the duodenum or diverted through the cystic duct into the gallbladder Secretion of Bile by the Liver • Physiologic Anatomy of Biliary Secretion b. Bile is stored and concentrated in the gallbladder Secretion of Bile by the Liver Table 64.2 Composition of Bile Liver Bile Gallbladder Bile 97.5 g/dl 92 g/dl Bile salts 1.1 g/dl 6 g/dl Bilirubin 0.04 g/dl 0.3 g/dl Cholesterol 0.1 g/dl 0.3-0.9 g/dl Fatty Acids 0.12 g/dl 0.3-1.2 g/dl Lecithin 0.04 g/dl 0.3 g/dl 145 mEq/L 130 mEq/L Potassium Ions 5 mEq/L 12 mEq/L Calcium Ions 5 mEq/L 23 mEq/L Chloride Ions 100 mEq/L 25 mEq/L Bicarbonate Ions 28 mEq/L 10 mEq/L Water Sodium Ions Secretion of Bile by the Liver Fig. 64.11 Liver secretion and gallbladder emptying Secretion of Bile by the Liver • Emptying of the Gallbladder-Role of CCK a. Most potent stimulus for the gallbladder to undergo rhythmic contractions when food enter the small intestine b. Main stimulus for CCK is fatty foods • Bile Salts Function in Digestion and Absorption a. Have a detergent action on fat particles which causes the emulsification of the fat b. Help in the absorption by forming micelles Secretion of Bile by the Liver Fig. 64.12 Formation of gallstones Secretion of the Small Intestine • Secretion of Mucus by Brunner’s Glands in the Duodenum a. Secrete large amounts of mucus in response to: tactile or irritating stimuli on the mucosa, vagal stimulation, or secretin b. Mucus protects the duodenal wall from the acidic chyme coming from the stomach c. Can be inhibited by sympathetic stimulation Secretion of the Small Intestine • Secretion of Intestinal Digestive Juices by the Crypts of Lieberkuhn a. Surface covered by goblet cells (mucus) and enterocytes (secrete water and electrolytes) b. Mechanism of secretion of the watery fluid is unclear but involves the active secretion of chloride ions and bicarbonate ions Secretion of the Small Intestine • Secretion of Intestinal Digestive Juices by the Crypts of Lieberkuhn c. Digestive enzymes in the small intestine secretion: several peptidases; sucrase, maltase, isomaltase, and lactase for splitting disaccharides into monosaccharides; and small amounts of intestinal lipase d. Regulation is entirely local by the enteric nervous system Secretion of the Small Intestine • Secretion of Mucus by the Large Intestine a. Many crypts but no villi in the large intestine b. Epithelial cells secrete almost no enzymes but contain many mucus cells c. Rate of mucus formation is regulated by the direct tactile stimulation of the epithelial cells