Chapter 23C Digestive System Slides by Barbara Heard and W. Rose. HESC310 12/5/2018 Chapter 23C Digestive System Slides by Barbara Heard and W. Rose. figures from Marieb & Hoehn 9th ed. Portions copyright Pearson Education Axial Skeleton

Digestive System Introduction/Overview Functional Anatomy HESC310 12/5/2018 Digestive System Introduction/Overview Functional Anatomy Physiology of Digestion & Absorption Chemical Digestion Absorption Axial Skeleton

Digestion Digestion Enzymes Hydrolysis Catabolic; macromolecules  monomers small enough for absorption Enzymes Intrinsic and accessory gland enzymes break down food Hydrolysis Water is added to break bonds © 2013 Pearson Education, Inc.

Digestion of Carbohydrates Only monosaccharides can be absorbed Monosaccharides absorbed as ingested Glucose, fructose, galactose Digestive enzymes Salivary amylase, pancreatic amylase, and brush border enzymes (dextrinase, glucoamylase, lactase, maltase, and sucrase) Break down disaccharides sucrose, lactose, maltose; polysaccharides glycogen and starch © 2013 Pearson Education, Inc.

Digestion of Carbohydrates Starch digestion Salivary amylase (saliva)  oligosaccharides at pH 6.75 – 7.00 Pancreatic amylase (small intestine)  breaks down any that escaped salivary amylase  oligosaccharides Brush border enzymes (dextrinase, glucoamylase, lactase, maltase, sucrase)  oligosaccharides  monosaccharides © 2013 Pearson Education, Inc.

Starch and disaccharides Carbohydrate digestion Foodstuff Enzyme(s) Site of action Path of absorption Starch and disaccharides Glucose and galactose are absorbed via cotransport with sodium ions. Fructose passes via facilitated diffusion. All monosaccharides leave the epithelial cells via facilitated diffusion, enter the capillary blood in the villi, and are transported to the liver via the hepatic portal vein. Salivary amylase Mouth Pancreatic amylase Small intestine Oligosaccharides and disaccharides Brush border enzymes in small intestine (dextrinase, gluco- amylase, lactase, maltase, and sucrase) Small intestine Lactose Maltose Sucrose Galactose Glucose Fructose © 2013 Pearson Education, Inc.

Digestion of Proteins Source is dietary, digestive enzymes, mucosal cells; digested to amino acid monomers Begins with pepsin in stomach at pH 1.5 – 2.5 Inactive in high pH of duodenum Pancreatic proteases Trypsin, chymotrypsin, and carboxypeptidase Brush border enzymes Aminopeptidases, carboxypeptidases, and dipeptidases © 2013 Pearson Education, Inc.

Protein digestion and absorption in the small intestine. Lumen of intestine Amino acids of protein fragments Brush border enzymes Pancreatic proteases Apical membrane (microvilli) Na+ 1. Pancreatic proteases & brush border proteases break down proteins to AAs. Absorptive epithelial cell Protein digestion and absorption in the small intestine. Na+ 2. Amino acids absorbed by active transport. Amino acid carrier 3. Amino acids leave by facilitated diffusion, enter capillaries. Capillary © 2013 Pearson Education, Inc.

Protein digestion Foodstuff Enzyme(s) and source Site of action Path of absorption Proteins Amino acids are absorbed via cotransport with sodium ions. Some dipeptides and tripeptides are absorbed via cotransport with H+ and hydrolyzed to amino acids within the cells. Infrequently, transcytosis of small peptides occurs. Amino acids leave the epithelial cells by facilitated diffusion, enter the capillary blood in the villi, and are transported to the liver via the hepatic portal vein. Stomach Pepsin (stomach glands) in presence of HCl Large polypeptides Pancreatic enzymes (trypsin, chymotrypsin, carboxypeptidase) Small intestine Small polypeptides, small peptides Brush border enzymes (aminopeptidase, carboxypeptidase, and dipeptidase) Small intestine Amino acids (some dipeptides and tripeptides) © 2013 Pearson Education, Inc.

Pre-treatment—emulsification by bile salts Enzymes—pancreatic lipases Digestion of Lipids Pre-treatment—emulsification by bile salts Does not break bonds Enzymes—pancreatic lipases  Fatty acids and monoglycerides © 2013 Pearson Education, Inc.

Emulsification, digestion, and absorption of fats. Fat globule Emulsification, digestion, and absorption of fats. Bile salts Bile salts in duodenum emulsify large fat globules. Pancreatic lipase yields free fatty acids and monoglycerides. These associate with bile salts to form micelles. Fat droplets coated with bile salts Micelles made up of fatty acids, monoglycerides, and bile salts Fatty acids and monoglycerides leave micelles and diffuse into epithelial cells. There they are recombined and packaged with other lipids & proteins to form chylomicrons. Chylomicrons are extruded from epithelial cells by exocytosis. Chylomicrons enter lacteals and are carried away from the intestine in lymph (chyle). Epithelial cells of small intestine Lacteal © 2013 Pearson Education, Inc.

Fat digestion Foodstuff Enzyme(s Site of action Path of absorption Unemulsified triglycerides Fatty acids and monoglycerides enter the intestinal cells via diffusion. Fatty acids and monoglycerides are recombined to form triglycerides and then combined with other lipids and proteins within the cells. The resulting chylomicrons are extruded by exocytosis. The chylomicrons enter the lacteals of the villi and are transported to the systemic circulation via the lymph in the thoracic duct. Some short-chain fatty acids are absorbed, move into the capillary blood in the villi by diffusion, and are transported to the liver via the hepatic portal vein. Lingual lipase Mouth Gastric lipase Stomach Emulsification by the detergent action of bile salts ducted in from the liver Small intestine Pancreatic lipases Small intestine Monoglycerides (or diglycerides with gastric lipase) and fatty acids © 2013 Pearson Education, Inc.

Digestion of Nucleic Acids Enzymes Pancreatic ribonuclease and deoxyribonuclease  nucleotide monomers Brush border enzyme nucleosidases and phosphatases  free bases, pentose sugars, phosphate ions © 2013 Pearson Education, Inc.

Nucleic acid digestion Foodstuff Enzyme(s) Site of action Path of absorption Nucleic acids Pancreatic ribo- nuclease and deoxyribonuclease Small intestine Units enter intestinal cells by active transport via membrane carriers. Units are absorbed into capillary blood in the villi and transported to the liver via the hepatic portal vein. Brush border enzymes (nucleosidases and phosphatases) Small intestine Pentose sugars, N-containing bases, phosphate ions © 2013 Pearson Education, Inc.

~ All food; 80% electrolytes; most water absorbed in small intestine Absorption ~ All food; 80% electrolytes; most water absorbed in small intestine Most prior to ileum Ileum reclaims bile salts Most absorbed by active transport  blood Exception - lipids © 2013 Pearson Education, Inc.

Absorption of Carbohydrates Glucose and galactose Secondary active transport (cotransport) with Na+  epithelial cells Move out of epithelial cells by facilitated diffusion  capillary beds in villi Fructose Facilitated diffusion to enter and exit cells © 2013 Pearson Education, Inc.

Absorption of Carbohydrates Glucose and galactose Secondary active transport (cotransport) with Na+  epithelial cells Move out of epithelial cells by facilitated diffusion  capillary beds in villi Fructose Facilitated diffusion to enter and exit cells © 2013 Pearson Education, Inc. 17

Amino acids transported by several types of carriers Absorption of Protein Amino acids transported by several types of carriers Most coupled to active transport of Na+ Dipeptides and tripeptides actively absorbed by H+-dependent cotransport; digested to amino acids within epithelial cells Enter capillary blood by diffusion © 2013 Pearson Education, Inc.

Homeostatic Imbalance Whole proteins not usually absorbed Can be taken up by endocytosis/exocytosis Most common in newborns  food allergies Usually disappear with mucosa maturation Allows IgA antibodies in breast milk to reach infant's bloodstream  passive immunity © 2013 Pearson Education, Inc.

Absorption of Lipids Absorption of monoglycerides and fatty acids Cluster with bile salts and lecithin to form micelles Released by micelles to diffuse into epithelial cells Combined with lecithin, phospholipids, cholesterol, & coated with proteins to form chylomicrons Enter lacteals; transported to systemic circulation Hydrolyzed to free fatty acids and glycerol by lipoprotein lipase of capillary endothelium Cells can use for energy or stored fat Absorption of short chain fatty acids Diffuse into portal blood for distribution © 2013 Pearson Education, Inc.

Absorption of Nucleic Acids Active transport across epithelium  bloodstream © 2013 Pearson Education, Inc.

Absorption of Vitamins In small intestine Fat-soluble vitamins (A, D, E, and K) carried by micelles; diffuse into absorptive cells Water-soluble vitamins (vitamin C and B vitamins) absorbed by diffusion or by passive or active transporters. Vitamin B12 (large, charged molecule) binds with intrinsic factor, and is absorbed by endocytosis © 2013 Pearson Education, Inc.

Absorption of Vitamins In large intestine Vitamin K and B vitamins from bacterial metabolism are absorbed © 2013 Pearson Education, Inc.

Absorption of Electrolytes Most ions actively along length of small intestine Iron and calcium are absorbed in duodenum Na+ coupled with active absorption of glucose and amino acids Cl– transported actively K+ diffuses in response to osmotic gradients; lost if poor water absorption Usually amount in intestine is amount absorbed © 2013 Pearson Education, Inc.

Absorption of Electrolytes Iron and calcium absorption related to need Ionic iron stored in mucosal cells with ferritin When needed, transported in blood by transferrin Ca2+ absorption regulated by vitamin D and parathyroid hormone (PTH) © 2013 Pearson Education, Inc.

9 L water, most from GI tract secretions, enter small intestine Absorption of Water 9 L water, most from GI tract secretions, enter small intestine 95% absorbed in the small intestine by osmosis Most of rest absorbed in large intestine Net osmosis occurs if concentration gradient established by active transport of solutes Water uptake coupled with solute uptake © 2013 Pearson Education, Inc.

Malabsorption of Nutrients Causes Anything that interferes with delivery of bile or pancreatic juice Damaged intestinal mucosa (e.g., bacterial infection; some antibiotics) © 2013 Pearson Education, Inc.

Malabsorption of Nutrients Gluten-sensitive enteropathy (celiac disease) Immune reaction to gluten Gluten causes immune cell damage to intestinal villi and brush border Treated by eliminating gluten from diet (all grains but rice and corn) © 2013 Pearson Education, Inc.

Examples of Anatomic Disorders of GI System Cleft palate and cleft lip Tracheoesophageal fistula Opening between esophagus and trachea Anovaginal fistula Can occur during vaginal childbirth; rare in developed countries where C sections are used; reatbale with surgery; “modern day lepers” © 2013 Pearson Education, Inc.

Genetic Disorder of GI System Cystic fibrosis Mutation in “CFTR” gene which codes for a chloride membrane channel protein Abnormal chloride transport causes thick mucus Mucus can block pancreatic duct and airways © 2013 Pearson Education, Inc.

Stomach and colon cancers rarely have early signs or symptoms Metastasized colon cancers frequently cause secondary liver cancer Prevention Regular dental and medical examination © 2013 Pearson Education, Inc.