2. Marc Imhotep Cray, M.D.
nml stomach, gross nml stomach, endoscopy nml esophagus, micro
nml esophagus, endoscopy nml sm intestine and mesentery, gross
Image Plates from: Klatt EC. Ch.7 - The Gastrointestinal Tract : In: Robbins and Cotran Atlas of Pathology, 3rd Ed. Philadelphia. PA : Saunders, 2015; 193-200.
nml transverse colon, endoscopy
3. Marc Imhotep Cray, M.D. 3
Photo: Colorized computed tomographic (CT) scan of an axial section through the abdomen. The image shows a gallstone (pink) obstructing the bile duct where it leaves the gallbladder (green
circle). The large yellow region around the gallbladder is the liver. a spine vertebra (pink) is visible in bottom center, with C-shaped kidneys (yellow) on either side.
From: Seeley’s Anatomy & Physiology 10th ed New York, NY: McGraw-Hill 2010
4. Marc Imhotep Cray, M.D.
Learning outcomes
4
After studying this presentation, you should be able to:
1. List the functions of the digestive system.
2. Describe the microscopic structure of the gastrointestinal tract.
3. Describe the structure and functions of the esophagus and stomach.
4. Describe the composition and actions of gastric juice and explain how
gastric secretion is regulated.
5. Describe the structure and functions of the small intestine.
6. Identify the location and describe the functions of the digestive enzymes
of the small intestine.
7. Describe the muscle contractions and movements of the small intestine.
8. Describe the structure and functions of the large intestine.
9. Explain the nature and significance of the intestinal microbiota.
5. Marc Imhotep Cray, M.D.
Learning outcomes cont.
5
After studying this presentation, you should be able to:
10. Describe the structure and functions of the liver.
11. Describe the synthesis, composition, and functions of bile and explain
the enterohepatic circulation.
12. Describe the composition of pancreatic juice and explain the significance
of pancreatic juice enzymes.
13. Identify the phases and explain the mechanisms of gastric regulation.
14. Explain the regulation of pancreatic juice and bile secretion.
15. Explain the significance of the enteric nervous system.
16. Describe the processes involved in the digestion and
absorption of carbohydrates and proteins.
17. Describe the processes involved in the digestion, absorption, and
transport of dietary lipids.
6. Marc Imhotep Cray, M.D.
Functions of the GI Tract
6
Motility:
Movement of food through GI tract
oIngestion:
• Taking food into the mouth
oMastication:
• Chewing food and mixing it with saliva
oDeglutition:
• Swallowing food
oPeristalsis:
• Rhythmic wave-like contractions that move food
through GI tract
7. Marc Imhotep Cray, M.D.
Functions of the GI Tract (2)
7
Secretion:
Includes both exocrine and endocrine secretions
oExocrine:
• HCl, H20, HC03
-, bile, lipase, pepsin, amylase, trypsin,
elastase, and histamine are secreted into lumen of GI
tract
oEndocrine:
• Stomach and small intestine secrete hormones to
help regulate GI system
Gastrin, secretin, CCK, GIP, GLP-1, guanylin, VIP,
and somatostatin
8. Marc Imhotep Cray, M.D.
Functions of the GI Tract (3)
8
Digestion:
Breakdown of food particles into subunits
(chemical structure change)
Absorption:
Process of passage of digestion (chemical subunits)
into blood or lymph
Storage and elimination:
• Temporary storage and elimination of indigestible
food
9. Marc Imhotep Cray, M.D. 9
GI tract divided into:
Alimentary canal
Accessory digestive
organs
GI tract is 30 ft. long and
extends from mouth to anus
Digestive System (GI Tract): Gross Anatomical
Arrangement
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
10. Marc Imhotep Cray, M.D.
Layers of GI Tract
10
Composed of 4 tunics:
• Mucosa
• Submucosa
• Muscularis
• Serosa
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
11. Marc Imhotep Cray, M.D.
Mucosa
11
Lines lumen of GI tract
Consists of simple columnar epithelium
o Lamina propria:
• Thin layer of connective tissue containing
lymph nodules
o Muscularis mucosae:
• Thin layer of smooth muscle responsible for
folds
Folds increase surface area for absorption
o Goblet cells:
• Secrete mucus
12. Marc Imhotep Cray, M.D.
Submucosa
12
Thick, highly vascular layer of connective tissue
Absorbed molecules enter blood and lymphatic
vessels
Submucosal plexus (Meissner’s plexus):
Provide autonomic nerve supply to muscularis
mucosae
13. Marc Imhotep Cray, M.D.
Muscularis
13
Responsible for segmental contractions and
peristaltic movement through GI tract
Inner circular layer of smooth muscle
Outer longitudinal layer of smooth muscle
o Contractions of these layers move food through tract
pulverize and mix food
Myenteric plexus located between 2 muscle layers
Major nerve supply to GI tract
o Fibers and ganglia from both sympathetic and parasympathetic
nervous systems
14. Marc Imhotep Cray, M.D.
Serosa
14
Binding and protective outer layer
Consists of areolar connective tissue covered with
simple squamous epithelium
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
15. Marc Imhotep Cray, M.D.
Regulation of GI Tract
15
Extrinsic innervation:
Parasympathetic nervous system (PNS):
oVagus and spinal nerves (preganglionic fibers):
• Stimulate motility and GI secretions
Sympathetic nervous system(SNS):
oPostganglionic sympathetic fibers that pass through
submucosal and myenteric plexuses and innervate
GI tract:
• Reduce peristalsis and secretory activity
16. Marc Imhotep Cray, M.D.
Regulation of the GI Tract (2)
16
Enteric (Intrinsic) nervous system (ENS):
Sites where parasympathetic fibers synapse with
postganglionic neurons that innervate smooth muscle
oSubmucosal and myenteric plexuses:
• Local regulation of GI tract
Paracrine secretion:
Molecules acting locally
Hormonal secretion:
Secreted by mucosa
17. Marc Imhotep Cray, M.D.
From Mouth to Stomach
17
Mastication (chewing):
Mixes food with saliva which contains salivary amylase
oEnzyme that can catalyze partial digestion of starch
Deglutition (swallowing):
Begins as a voluntary activity Involves 3 phases:
oOral phase is voluntary
oPharyngeal and esophageal phases are involuntary
• Cannot be stopped
Larynx is raised
Epiglottis covers entrance to respiratory tract
18. Marc Imhotep Cray, M.D.
From Mouth to Stomach cont.
18
Involuntary muscular contractions and relaxations in
mouth, pharynx, larynx, and esophagus are
coordinated by swallowing center in medulla
Esophagus:
• Connects pharynx to stomach
• Upper third contains skeletal muscle
• Middle third contains a mixture of skeletal and smooth
muscle
• Terminal (lower third) portion contains only smooth muscle
19. Marc Imhotep Cray, M.D. 19
Peristalsis:
Produced by a series of localized
reflexes in response to distention of
wall by bolus
oWave-like muscular contractions:
• Circular smooth muscle contract
behind, relaxes in front of bolus
• Followed by longitudinal contraction
(shortening) of smooth muscle rate
of 2-4 cm/sec
• After food passes into stomach, LES
constricts
Esophagus
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
20. Marc Imhotep Cray, M.D.
Stomach
20
Most distensible part of GI tract empties
into duodenum
Functions of stomach:
Stores food
Initiates digestion of proteins
Kills bacteria
Moves food (chyme) into intestine
21. Marc Imhotep Cray, M.D. 21
Contractions of stomach churn chyme
Mix chyme w gastric secretions
Push food into intestine
Stomach cont.
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
22. Marc Imhotep Cray, M.D.
Stomach cont.
22
Gastric mucosa has
gastric pits in folds
Cells that line folds
deeper in mucosa are
gastric glands
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
23. Marc Imhotep Cray, M.D.
Gastric Glands
23
Secrete gastric juice:
Goblet cells mucus
Parietal cells HCl and intrinsic factor
Chief cells pepsinogen
Enterochromaffin-like cells (ECL) histamine and serotonin
G cells gastrin
D cells somatostatin
Stomach ghrelin
24. Marc Imhotep Cray, M.D. 24
Parietal cells secrete H+ into
gastric lumen by primary
active transport, through H+/
K+ ATPase pump
Parietal cell’s basolateral
membrane takes in Cl-
against its electrochemical
gradient, by coupling its
transport with HC03
-
HCl Production
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
25. Marc Imhotep Cray, M.D.
HCl Production cont.
25
HCl production is stimulated:
Indirectly by gastrin
Indirectly by Ach
ACh and gastrin stimulate release of histamine
Histamine stimulates parietal cells to secrete HCl
26. Marc Imhotep Cray, M.D. 26
Makes gastric juice very acidic
Denatures ingested proteins (alter
tertiary structure) so become more
digestible
Activates pepsinogen to pepsin
Pepsin is more active at pH of 2.0
HCl Functions
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
27. Marc Imhotep Cray, M.D.
Digestion and Absorption in Stomach
27
Proteins partially digested by pepsin
Carbohydrate digestion by salivary amylase is
soon inactivated by acidity
Alcohol and aspirin are only commonly
ingested substances absorbed
28. Marc Imhotep Cray, M.D.
Gastric and Peptic Ulcers
28
Peptic ulcers:
• Erosions of mucous membranes of stomach or duodenum
produced by action of HCl
Zollinger-Ellison syndrome:
• Ulcers of duodenum are produced by excessive gastric acid
secretions
Helicobacter pylori:
• Bacterium that resides in GI tract that may produce ulcers
Acute gastritis:
• Histamine released by tissue damage and inflammation
stimulate further acid secretion
29. Marc Imhotep Cray, M.D.
Protective Mechanisms of Stomach
29
Parietal and chief cells impermeable to HCl
Alkaline mucus contains HC03
-
Tight junctions between adjacent epithelial
cells
Rapid rate of cell division (entire epithelium
replaced in 3 days)
Prostaglandins inhibit gastric secretions
30. Marc Imhotep Cray, M.D.
Small Intestine
30
Each villus is a fold in mucosa
Covered w columnar epithelial
cells interspersed w goblet cells
Epithelial cells at tips of villi are
exfoliated and replaced by mitosis
in crypt of Lieberkuhn
Lamina propria contain
lymphocytes, capillaries, and
central lacteal Fox SI. Human Physiology 12th ed. New York, NY:
McGraw-Hill, 2011.
31. Marc Imhotep Cray, M.D.
Absorption in Small Intestine
31
Duodenum and jejunum:
Carbohydrates, amino acids, lipids, iron, and Ca2+
Ileum:
Bile salts, vitamin B12, electrolytes, and H20
32. Marc Imhotep Cray, M.D.
Intestinal Enzymes
32
• Microvilli contain brush border enzymes that are not secreted
into the lumen.
• Brush border enzymes remain attached to the cell membrane with
their active sites exposed to the chyme.
• Absorption requires both brush border enzymes and
pancreatic enzymes.
33. Marc Imhotep Cray, M.D.
Intestinal Contractions and Motility
33
2 major types of contractions occur
in small intestine:
Peristalsis:
oSlow movement
oPressure at pyloric end of
small intestine is greater than
at distal end
Segmentation:
oMajor contractile activity of
small intestine
oContraction of circular
smooth muscle
• Mix chyme
Insert fig. 18.14
Fox SI. Human Physiology 12th ed. New York, NY:
McGraw-Hill, 2011.
34. Marc Imhotep Cray, M.D.
Contractions of Intestinal Smooth Muscles
34
Occur automatically in response
to endogenous pacemaker
activity
Rhythm of contractions is paced
by graded depolarizations called
slow waves
Slow waves produced by interstitial
cells of Cajal
Slow waves spread from 1 smooth
muscle cell to another through
nexuses
Fox SI. Human Physiology 12th ed. New York, NY:
McGraw-Hill, 2011.
35. Marc Imhotep Cray, M.D. 35
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
36. Marc Imhotep Cray, M.D.
Contractions of Intestinal Smooth Muscles
36
When slow waves rise above threshold triggers APs by opening of VG
Ca2+ channels
Inward flow of Ca2+:
oProduces upward depolarization phase
oStimulates contraction of smooth muscle
Repolarization:
VG K+ channels open
oSlow waves decrease in amplitude as they are conducted.
May stimulate contraction in proportion to magnitude of
depolarization
Parasympathetic NS, stretch and gastrin increase amplitude of slow
waves
Stimulate APs
SNS decrease APs
37. Marc Imhotep Cray, M.D. 37
-55
+30
Vg Ca++ Channel
Vg K+ Channel
Intestinal Smooth Muscle Action Potential
Fox SI. Human Physiology 12th ed. New York, NY:
McGraw-Hill, 2011.
38. Marc Imhotep Cray, M.D.
Cells and Electrical Events in Muscularis
38
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
39. Marc Imhotep Cray, M.D.
Large Intestine
39
Outer surface bulges outward to form haustra
Little absorptive function
oAbsorbs H20, electrolytes, several vitamin B complexes, vitamin K,
and folic acid
• Intestinal microbiota produce significant amounts of folic acid and vitamin
K
• Bacteria ferment indigestible molecules to produce short-chain fatty acids
• Does not contain villi
Secretes H20, via active transport of NaCl into intestinal lumen
Guanylin stimulates secretion of Cl- and H20, and inhibits absorption
of Na+ (minor pathway)
o Membrane contains Na+/K+ pumps
• Minor pathway
40. Marc Imhotep Cray, M.D.
Fluid and Electrolyte Absorption in Intestine
40
Small intestine:
Most of fluid and electrolytes are absorbed by small
intestine
Absorption of H20 occurs passively as a result of osmotic
gradient created by active transport
oAldosterone stimulates NaCl and H20 absorption in ileum
Large intestine:
Absorbs about 90% of remaining volume
oAbsorption of H20 occurs passively as a result of the osmotic
gradient created by active transport of Na+ and Cl-
41. Marc Imhotep Cray, M.D.
Defecation
41
Waste material passes to rectum
Occurs when rectal pressure rises and external
anal sphincter relaxes
Defecation reflex:
Longitudinal rectal muscles contract to increase rectal
pressure
o Relaxation of internal anal sphincter
Excretion is aided by contractions of abdominal and
pelvic skeletal muscles
oPush feces from the rectum
42. Marc Imhotep Cray, M.D.
Structure of Liver
42
Liver largest internal organ
Hepatocytes form hepatic plates that are 1–2 cells thick
Arranged into functional units called lobules
Plates separated by sinusoids
More permeable than other capillaries
Contains phagocytic Kupffer cells
Secretes bile into bile canaliculi which are drained
by bile ducts
43. Marc Imhotep Cray, M.D.
Structure of Liver (2)
43
Insert fig. 18.20
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
44. Marc Imhotep Cray, M.D.
Hepatic Portal System
44
Products of digestion that are absorbed are delivered
to liver
Capillaries drain into hepatic portal vein, which carries
blood to liver
¾ blood is deoxygenated
Hepatic vein drains liver
45. Marc Imhotep Cray, M.D. 45
Compounds that recirculate
between liver and intestine
Many compounds can be absorbed
through small intestine and enter
hepatic portal blood
Variety of exogenous compounds
are secreted by liver into bile ducts
Can excrete these compounds
into intestine with bile
Enterohepatic Circulation
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
46. Marc Imhotep Cray, M.D.
Major Categories of Liver Function
46
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
47. Marc Imhotep Cray, M.D.
Bile Production and Secretion
47
Liver produces and secretes 250–1500 ml of bile/day
Bile pigment (bilirubin) is produced in spleen, bone marrow,
and liver
Derivative of heme groups (without iron) from hemoglobin.
Free bilirubin combines with glucuronic acid and forms
conjugated bilirubin
Secreted into bile
Converted by bacteria in intestine to urobilinogen
Urobilogen is absorbed by intestine and enters hepatic vein
oRecycled, or filtered by kidneys and excreted in urine
48. Marc Imhotep Cray, M.D.
Metabolism of Heme and Bilirubin
48
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
49. Marc Imhotep Cray, M.D.
Bile Production and Secretion (2)
49
Bile acids are derivatives of
cholesterol
Major pathway of cholesterol
breakdown in body
Principal bile acids are:
Cholic acid
Chenodeoxycholic acid
o Combine with glycine or taurine
to form bile salts Bile salts
aggregate as micelles
95% of bile acids are absorbed by
ileum Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
50. Marc Imhotep Cray, M.D.
Detoxification of Blood
50
Liver can remove hormones, drugs, and other
biologically active molecules from blood by:
Excretion into the bile
Phagocytosis by Kupffer cells
Chemical alteration of the molecules
oAmmonia is produced by deamination of amino acids in
liver
oLiver converts it into urea
• Excreted in urine
51. Marc Imhotep Cray, M.D.
Detoxification of the Blood cont.
51
Inactivation of steroid hormones and drugs
Conjugation of steroid hormones and xenobiotics
make them anionic
oCan be transported into bile by multispecific organic
anion transport carriers
Steroid and xenobiotic receptors stimulate
production of cytochrome P450 enzymes
52. Marc Imhotep Cray, M.D.
Secretion of Glucose, Triglycerides and
Ketones
52
Liver helps regulate blood glucose
concentration by:
Glycogenesis and lipogenesis
Glycogenolysis and gluconeogenesis
Contains enzymes required to convert free fatty
acids into ketone bodies
53. Marc Imhotep Cray, M.D.
Production of Plasma Proteins
53
Albumin and most of plasma globulins (except
immunoglobulins) are produced by liver
Albumin:
Constitutes 70% of total plasma protein
oContributes most to colloid osmotic pressure in blood
Globulins:
Transport cholesterol and hormones
Inhibit trypsin
Produce blood clotting factors I, II, III, V, VII, IX, XI
54. Marc Imhotep Cray, M.D.
Gallbladder
54
Sac-like organ attached to inferior surface of
liver
Stores and concentrates bile
When gallbladder fills with bile, it expands
Contraction of muscularis layer of gallbladder
ejects bile into common bile duct into duodenum
When small intestine is empty, sphincter of
Oddi closes
Bile is forced up to cystic duct to gallbladder
55. Marc Imhotep Cray, M.D. 55
Pancreas
Exocrine:
Acini:
oSecrete pancreatic juice
Endocrine:
Islets of Langerhans:
oSecrete insulin and
glucagon
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
56. Marc Imhotep Cray, M.D.
Pancreatic Juice
56
• Contains H20, HC03
- and digestive enzymes
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
57. Marc Imhotep Cray, M.D.
Pancreatic Juice
57
• Complete digestion of food
requires action of both
pancreatic and brush border
enzymes.
• Most pancreatic enzymes are
produced as zymogens.
• Trypsin (when activated by
enterokinase) triggers the
activation of other pancreatic
enzymes.
• Pancreatic trypsin inhibitor
attaches to trypsin.
• Inhibits its activity in the
pancreas. Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
58. Marc Imhotep Cray, M.D.
Neural and Endocrine Regulation
58
Neural and endocrine mechanisms modify activity
of GI system
GI tract is both an endocrine gland, and a target for
action of hormones
59. Marc Imhotep Cray, M.D.
Regulation of Gastric Function
59
Gastric motility and secretion are automatic
Waves of contraction are initiated
spontaneously by pacesetter cells
Extrinsic control of gastric function is divided
into 3 phases:
Cephalic phase
Gastric phase
Intestinal phase
60. Marc Imhotep Cray, M.D.
Cephalic Phase
60
Stimulated by sight, smell, and taste of food
Activation of vagus:
Stimulates chief cells to secrete pepsinogen
Directly stimulates G cells to secrete gastrin
Directly stimulates ECL cells to secrete histamine
Indirectly stimulates parietal cells to secrete HCl
Continues into 1st 30 min. of a meal
61. Marc Imhotep Cray, M.D.
Gastric Phase
61
Arrival of food in stomach stimulates gastric phase
Gastric secretion stimulated by:
oDistension
oChemical nature of chyme (amino acids and short
polypeptides)
• Stimulates G cells to secrete gastrin
• Stimulates chief cells to secrete pepsinogen
• Stimulates ECL cells to secrete histamine
Histamine stimulates secretion of HCl
oPositive feedback effect
• As more HCl and pepsinogen are secreted, more polypeptides
and amino acids are released
62. Marc Imhotep Cray, M.D.
Gastric Phase cont.
62
Secretion of HCl is also regulated
by a negative feedback effect:
HCl secretion decreases if pH
< 2.5
At pH of 1.0, gastrin secretion
ceases
oD cells stimulate secretion
of somatostatin
Paracrine regulator to
inhibit secretion of gastrin
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
63. Marc Imhotep Cray, M.D.
Intestinal Phase
63
Inhibits gastric activity when chyme enters small
intestine
Arrival of chyme increases osmolality and distension
Activates sensory neurons of vagus and produces an
inhibitory neural reflex:
oInhibits gastric motility and secretion
oIn presence of fat, enterogasterone inhibits gastric motility
and secretion
Hormone secretion:
Inhibit gastric activity:
oSomatostatin, CCK, and GLP-1
64. Marc Imhotep Cray, M.D.
Enteric Nervous System
64
Submucosal and myenteric plexuses contain 100
million neurons
Include preganglionic parasympathetic axons,
ganglion cell bodies, postganglionic sympathetic
axons; and afferent intrinsic and extrinsic sensory
neurons
65. Marc Imhotep Cray, M.D.
Enteric Nervous System cont.
65
Peristalsis:
ACh and substance P
stimulate smooth muscle
contraction above bolus
NO, VIP, and ATP stimulate
smooth muscle relaxation
below bolus
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
66. Marc Imhotep Cray, M.D.
Paracrine Regulators of Intestine
66
Serotonin (5-HT):
Stimulates intrinsic afferents, which send impulses into
intrinsic nervous system; and activates motor neurons
Motilin:
Stimulates contraction of duodenum and stomach antrum.
Guanylin:
Activates guanylate cyclase, stimulating production of cGMP
ocGMP stimulates intestinal cells to secrete Cl- and H20
• Inhibits the absorption of Na+
Uroguanylin:
May stimulate kidneys to secrete salt in urine.
67. Marc Imhotep Cray, M.D.
Intestinal Reflexes
67
Intrinsic and extrinsic regulation controlled by
intrinsic and paracrine regulators
Gastroileal reflex:
Increased gastric activity causes increased motility of ileum
and movement of chyme through ileocecal sphincter
Ileogastric reflex:
Distension of ileum, decreases gastric motility
Intestino-intestinal reflex:
Overdistension in 1 segment, causes relaxation throughout
rest of intestine
68. Marc Imhotep Cray, M.D.
Secretion of Pancreatic Juice
68
Secretion of pancreatic juice and bile is stimulated by:
Secretin:
oOccurs in response to duodenal pH < 4.5
oStimulates production of HC03
- by pancreas
oStimulates the liver to secrete HC03
- into the bile
CCK:
oOccurs in response to fat and protein content of chyme in
duodenum
o Stimulates production of pancreatic enzymes
oEnhances secretin
oStimulates contraction of sphincter of Oddi
69. Marc Imhotep Cray, M.D.
Digestion and Absorption of Carbohydrates
69
Salivary amylase:
Begins starch digestion
Pancreatic amylase:
Digests starch to oligosaccharides
Oligosaccharides hydrolyzed by
brush border enzymes
Glucose is transported by
secondary active transport with
Na+ into the capillaries
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
70. Marc Imhotep Cray, M.D.
Digestion and Absorption of Protein
70
Digestion begins in stomach when pepsin digests
proteins to form polypeptides
In duodenum and jejunum:
Endopeptidases cleave peptide bonds in interior of
polypeptide:
oTrypsin
oChymotrypsin
oElastase
Exopeptidases cleave peptide bonds from the ends of the
polypeptide:
oCarboxypeptidase
o Aminopeptidase
71. Marc Imhotep Cray, M.D. 71
Free amino acids absorbed by
cotransport with Na+
Dipeptides and tripeptides
transported by secondary active
transport using a H+ gradient to
transport them into cytoplasm
Hydrolyzed into free amino acids
and then secreted into blood
Digestion and Absorption of Protein cont.
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.
72. Marc Imhotep Cray, M.D.
Digestion and Absorption of Lipids
72
Arrival of lipids in duodenum serves as a stimulus for
secretion of bile
Emulsification:
Bile salt micelles are secreted into duodenum to break up
fat droplets
Pancreatic lipase and colipase hydrolyze triglycerides
to free fatty acids and monoglycerides
Colipase coats the emulsification droplets and anchors
lipase enzyme to them
Form micelles and move to brush border
73. Marc Imhotep Cray, M.D.
Digestion and Absorption of Lipids cont.
73
Free fatty acids, monoglycerides, and
lysolecithin leave micelles and enter into
epithelial cells
Resynthesize triglycerides and phospholipids
within cell
oCombine with a protein to form chylomicrons.
Secreted into central lacteals
74. Marc Imhotep Cray, M.D.
Transport of Lipids
74
In blood, lipoprotein lipase hydrolyzes
triglycerides to free fatty acids and glycerol for
use in cells
Remnants containing cholesterol are taken to
the liver
Form VLDLs which take triglycerides to cells
Once triglycerides are removed, VLDLs are
converted to LDLs
oLDLs transport cholesterol to organs and blood vessels
HDLs transport excess cholesterol back to liver
75. Marc Imhotep Cray, M.D.
Absorption of Fat
75
Fox SI. Human Physiology 12th ed. New York, NY: McGraw-Hill, 2011.