Circulatory system which circulates lymph.

[1] The passage of lymph for example takes much

longer than that of blood.[2] Blood is a fluid consisting of plasma, red blood
Circulatory system cells, white blood cells, and platelets that is circulated by the heart through
the vertebrate vascular system, carrying oxygen and nutrients to and waste
materials away from all body tissues. Lymph is essentially recycled excess
blood plasma after it has been filtered from the interstitial fluid (between
cells) and returned to the lymphatic system. The cardiovascular (from Latin
words meaning "heart" and "vessel") system comprises the blood, heart, and
blood vessels.[3] The lymph, lymph nodes, and lymph vessels form the
lymphatic system, which returns filtered blood plasma from the interstitial
fluid (between cells) as lymph.

While humans, as well as other vertebrates, have a closed cardiovascular

system (meaning that the blood never leaves the network of arteries, veins
and capillaries), some invertebrate groups have an open cardiovascular
system. The lymphatic system, on the other hand, is an open system
providing an accessory route for excess interstitial fluid to be returned to the
blood.[4] The more primitive, diploblastic animal phyla lack circulatory
systems.

Structure

Cardiovascular system

The human circulatory system (simplified). Red indicates

oxygenated blood carried in arteries, blue indicates
deoxygenated blood carried in veins. Capillaries, which
join the arteries and veins, and the lymphatic vessels are
not shown.

The circulatory system, also called the cardiovascular system or the

vascular system, is an organ system that permits blood to circulate and
transport nutrients (such as amino acids and electrolytes), oxygen, carbon
dioxide, hormones, and blood cells to and from the cells in the body to
provide nourishment and help in fighting diseases, stabilize temperature and
pH, and maintain homeostasis. The study of the blood flow is called
hemodynamics. The study of the properties of the blood flow is called
hemorheology.
Depiction of the heart, major veins and arteries constructed from body scans.
The circulatory system is often seen to comprise two separate systems: the
cardiovascular system, which distributes blood, and the lymphatic system,

Cross section of a human artery
Relative percentages of cardiac output delivered to major organ systems
The essential components of the human cardiovascular system are the heart,
blood and blood vessels.[5] It includes the pulmonary circulation, a "loop"
through the lungs where blood is oxygenated; and the systemic circulation, a
"loop" through the rest of the body to provide oxygenated blood. The
systemic circulation can also be seen to function in two parts–a
macrocirculation and a microcirculation. An average adult contains five to
six quarts (roughly 4.7 to 5.7 liters) of blood, accounting for approximately
7% of their total body weight.[6] Blood consists of plasma, red blood cells,
white blood cells, and platelets. Also, the digestive system works with the
circulatory system to provide the nutrients the system needs to keep the heart
pumping.[7]
The cardiovascular systems of humans are closed, meaning that the blood
never leaves the network of blood vessels. In contrast, oxygen and nutrients
diffuse across the blood vessel layers and enter interstitial fluid, which
carries oxygen and nutrients to the target cells, and carbon dioxide and
wastes in the opposite direction. The other component of the circulatory
system, the lymphatic system, is open.
Arteries
See also: Arterial tree
Oxygenated blood enters the systemic circulation when leaving the left
ventricle, through the aortic semilunar valve. The first part of the systemic
circulation is the aorta, a massive and thick-walled artery. The aorta arches
and gives branches supplying the upper part of the body. after passing
through the aortic opening of the diaphragm at the level of thoracic ten
vertebra, it enters the abdomen. Later it descends down and supplies
branches to abdomen, pelvis, perineum and the lower limbs. According to
Difore's Atlas of Histology the walls of aorta are elastic. This elasticity helps
to maintain the blood pressure throughout the body. When the aorta receives
almost 5 L of blood from the heart, it recoils and is responsible for pulsating
B.P. Moreover, as aorta branches into smaller arteries, their elasticity goes on
decreasing and their compliance goes on increasing.
Capillaries
Arteries branch into small passages called arterioles and then into the
capillaries.[8] The capillaries merge to bring blood into the venous system.[9]
Veins
After their passage through body tissues, capillaries merge once again into
venules, which continue to merge into veins. The venous system finally
coalesces into two major veins: the superior vena cava (roughly speaking
draining the areas above the heart) and the inferior vena cava (roughly
speaking from areas below the heart). These two great vessels empty into the
right atrium of the heart.
Coronary vessels
Main article: Coronary circulation
The heart itself is supplied with oxygen and nutrients through a small "loop"
of the systemic circulation and derives very little from the blood contained
within the four chambers.
Portal veins
The general rule is that arteries from the heart branch out into capillaries,
which collect into veins leading back to the heart. Portal veins are a slight
exception to this. In humans the only significant example is the hepatic portal
vein which combines from capillaries around the gut where the blood absorbs
the various products of digestion; rather than leading directly back to the
heart, the hepatic portal vein branches into a second capillary system in the
liver.
Heart
Main article: Heart
View from the front
The heart pumps oxygenated blood to the body and deoxygenated blood to
the lungs. In the human heart there is one atrium and one ventricle for each
circulation, and with both a systemic and a pulmonary circulation there are
four chambers in total: left atrium, left ventricle, right atrium and right
ventricle. The right atrium is the upper chamber of the right side of the heart.
The blood that is returned to the right atrium is deoxygenated (poor in
oxygen) and passed into the right ventricle to be pumped through the
pulmonary artery to the lungs for re-oxygenation and removal of carbon
dioxide. The left atrium receives newly oxygenated blood from the lungs as
well as the pulmonary vein which is passed into the strong left ventricle to be
pumped through the aorta to the different organs of the body.
The coronary circulation system provides a blood supply to the heart muscle
itself. The coronary circulation begins near the origin of the aorta by two
arteries: the right coronary artery and the left coronary artery. After
nourishing the heart muscle, blood returns through the coronary veins into
the coronary sinus and from this one into the right atrium. Back flow of
blood through its opening during atrial systole is prevented by the Thebesian
valve. The smallest cardiac veins drain directly into the heart chambers.[7]
Lungs
The pulmonary circulation as it passes from the heart. Showing both the
pulmonary artery and bronchial arteries.
Main article: Pulmonary circulation
The circulatory system of the lungs is the portion of the cardiovascular
system in which oxygen-depleted blood is pumped away from the heart, via
the pulmonary artery, to the lungs and returned, oxygenated, to the heart via
the pulmonary vein.
Oxygen deprived blood from the superior and inferior vena cava enters the
right atrium of the heart and flows through the tricuspid valve (right
atrioventricular valve) into the right ventricle, from which it is then pumped
through the pulmonary semilunar valve into the pulmonary artery to the
lungs. Gas exchange occurs in the lungs, whereby CO2 is released from the
blood, and oxygen is absorbed. The pulmonary vein returns the now oxygen-
rich blood to the left atrium.[7]
heart for return to the cardiovascular system, by emptying into the lymphatic
ducts. Its other main function is in the adaptive immune system.[10]
Physiology

A separate system known as the bronchial circulation supplies blood to the

tissue of the larger airways of the lung.

Systemic circulation

The systemic circulation is the circulation of the blood to all parts of the
body except the lungs. Systemic circulation is the portion of the
cardiovascular system which transports oxygenated blood away from the
heart through the aorta from the left ventricle where the blood has been
previously deposited from pulmonary circulation, to the rest of the body, and
returns oxygen-depleted blood back to the heart.[7]
Brain
Main article: Cerebral circulation
Animation of a typical human red blood cell cycle in the circulatory system.
This animation occurs at a faster rate (~20 seconds of the average 60-second
cycle) and shows the red blood cell deforming as it enters capillaries, as well
as the bars changing color as the cell alternates in states of oxygenation along
the circulatory system.
Main article: Blood § Oxygen transport

About 98.5% of the oxygen in a sample of arterial blood in a healthy human,

The brain has a dual blood supply that comes from arteries at its front and
back. These are called the "anterior" and "posterior" circulation respectively.
The anterior circulation arises from the internal carotid arteries and supplies
the front of the brain. The posterior circulation arises from the vertebral
arteries, and supplies the back of the brain and brainstem. The circulation
from the front and the back join together (anastomise) at the Circle of Willis.
Kidneys
The renal circulation receives around 20% of the cardiac output. It branches
from the abdominal aorta and returns blood to the ascending vena cava. It is
the blood supply to the kidneys, and contains many specialized blood vessels.
Lymphatic system
The lymphatic system is part of the circulatory system. It is a network of
lymphatic vessels and lymph capillaries, lymph nodes and organs, and
lymphatic tissues and circulating lymph. One of its major functions is to
carry the lymph, draining and returning interstitial fluid back towards the
breathing air at sea-level pressure, is chemically combined with hemoglobin
molecules. About 1.5% is physically dissolved in the other blood liquids and
not connected to hemoglobin. The hemoglobin molecule is the primary
transporter of oxygen in mammals and many other species.
Development
Main article: Fetal circulation
The development of the circulatory system starts with vasculogenesis in the
embryo. The human arterial and venous systems develop from different areas
in the embryo. The arterial system develops mainly from the aortic arches,
six pairs of arches which develop on the upper part of the embryo. The
venous system arises from three bilateral veins during weeks 4 – 8 of
embryogenesis. Fetal circulation begins within the 8th week of development.
Fetal circulation does not include the lungs, which are bypassed via the
truncus arteriosus. Before birth the fetus obtains oxygen (and nutrients) from
the mother through the placenta and the umbilical cord.[11]
Arterial development
Main article: Aortic arches
The human arterial system originates from the aortic arches and from the
dorsal aortae starting from week 4 of embryonic life. The first and second
aortic arches regress and forms only the maxillary arteries and stapedial
arteries respectively. The arterial system itself arises from aortic arches 3, 4
and 6 (aortic arch 5 completely regresses).
The dorsal aortae, present on the dorsal side of the embryo, are initially
present on both sides of the embryo. They later fuse to form the basis for the
aorta itself. Approximately thirty smaller arteries branch from this at the back
and sides. These branches form the intercostal arteries, arteries of the arms
and legs, lumbar arteries and the lateral sacral arteries. Branches to the sides
of the aorta will form the definitive renal, suprarenal and gonadal arteries.
Finally, branches at the front of the aorta consist of the vitelline arteries and
umbilical arteries. The vitelline arteries form the celiac, superior and inferior
mesenteric arteries of the gastrointestinal tract. After birth, the umbilical
arteries will form the internal iliac arteries.
Venous development
The human venous system develops mainly from the vitelline veins, the
umbilical veins and the cardinal veins, all of which empty into the sinus
venosus.
Clinical significance
Many diseases affect the circulatory system. This includes cardiovascular
disease, affecting the cardiovascular system, and lymphatic disease affecting
the lymphatic system. Cardiologists are medical professionals which
specialise in the heart, and cardiothoracic surgeons specialise in operating on
the heart and its surrounding areas. Vascular surgeons focus on other parts of
the circulatory system.
Cardiovascular disease
Main article: Cardiovascular disease
Diseases affecting the cardiovascular system are called cardiovascular
disease.
Many of these diseases are called "lifestyle diseases" because they develop
over time and are related to a person's exercise habits, diet, whether they
smoke, and other lifestyle choices a person makes. Atherosclerosis is the
precursor to many of these diseases. It is where small atheromatous plaques
build up in the walls of medium and large arteries. This may eventually grow
or rupture to occlude the arteries. It is also a risk factor for acute coronary
syndromes, which are diseases which are characterised by a sudden deficit of
oxygenated blood to the heart tissue. Atherosclerosis is also associated with
problems such as aneurysm formation or splitting ("dissection") of arteries.
Another major cardiovascular disease involves the creation of a clot, called a
"thrombus". These can originate in veins or arteries. Deep venous
thrombosis, which mostly occurs in the legs, is one cause of clots in the veins
of the legs, particularly when a person has been stationary for a long time.
These clots may embolise, meaning travel to another location in the body.
The results of this may include pulmonary embolus, transient ischaemic
attacks, or stroke.
Cardiovascular diseases may also be congenital in nature, such as heart
defects or persistent fetal circulation, where the circulatory changes that are
supposed to happen after birth do not. Not all congenital changes to the
circulatory system are associated with diseases, a large number are
anatomical variations.
Measurement techniques
Magnetic resonance angiography of aberrant subclavian artery
The function and health of the circulatory system and its parts are measured
in a variety of manual and automated ways. These include simple methods
such as those that are part of the cardiovascular examination, including the
taking of a person's pulse as an indicator of a person's heart rate, the taking of
blood pressure through a sphygmomanometer or the use of a stethoscope to
listen to the heart for murmurs which may indicate problems with the heart's
valves. An electrocardiogram can also be used to evaluate the way in which
electricity is conducted through the heart.
Other more invasive means can also be used. A cannula or catheter inserted
into an artery may be used to measure pulse pressure or pulmonary wedge
pressures. Angiography, which involves injecting a dye into an artery to
visualise an arterial tree, can be used in the heart (coronary angiography) or
brain. At the same time as the arteries are visualised, blockages or
narrowings may be fixed through the insertion of stents, and active bleeds
may be managed by the insertion of coils. An MRI may be used to image
arteries, called an MRI angiogram. For evaluation of the blood supply to the
lungs a CT pulmonary angiogram may be used.
Ultrasound can also be used, particularly to identify the health of blood
vessels, and a Doppler ultrasound of the carotid arteries or Doppler
ultrasound of the lower limbs can be used to evaluate for narrowing of the
carotid arteries or thrombus formation in the legs, respectively.
Surgery
There are a number of surgical procedures performed on the circulatory
system:
 Coronary artery bypass surgery
 Coronary stent used in angioplasty
 Vascular surgery
 Vein stripping
 Cosmetic procedures
Cardiovascular procedures are more likely to be performed in an inpatient
setting than in an ambulatory care setting; in the United States, only 28% of
cardiovascular surgeries were performed in the ambulatory care setting.[12]
Other animals
Other vertebrates
This section needs expansion. You can help by adding to it. (September
2015)
Two-chambered heart of a fish
The circulatory systems of all vertebrates, as well as of annelids (for
example, earthworms) and cephalopods (squids, octopuses and relatives) are
closed, just as in humans. Still, the systems of fish, amphibians, reptiles, and
birds show various stages of the evolution of the circulatory system.
In fish, the system has only one circuit, with the blood being pumped through
the capillaries of the gills and on to the capillaries of the body tissues. This is
known as single cycle circulation. The heart of fish is, therefore, only a single
pump (consisting of two chambers).
In amphibians and most reptiles, a double circulatory system is used, but the
heart is not always completely separated into two pumps. Amphibians have a
three-chambered heart.
In reptiles, the ventricular septum of the heart is incomplete and the
pulmonary artery is equipped with a sphincter muscle. This allows a second
possible route of blood flow. Instead of blood flowing through the pulmonary
artery to the lungs, the sphincter may be contracted to divert this blood flow
through the incomplete ventricular septum into the left ventricle and out
through the aorta. This means the blood flows from the capillaries to the
heart and back to the capillaries instead of to the lungs. This process is useful
to ectothermic (cold-blooded) animals in the regulation of their body
temperature.
Birds, mammals, and crocodilians show complete separation of the heart into
two pumps, for a total of four heart chambers; it is thought that the four-
chambered heart of birds and crocodilians evolved independently from that
of mammals.[13]
Open circulatory system
See also: Hemolymph
The open circulatory system is a system in which a fluid in a cavity called the
hemocoel bathes the organs directly with oxygen and nutrients and there is
no distinction between blood and interstitial fluid; this combined fluid is
called hemolymph or haemolymph.[14] Muscular movements by the animal
during locomotion can facilitate hemolymph movement, but diverting flow
from one area to another is limited. When the heart relaxes, blood is drawn
back toward the heart through open-ended pores (ostia).
Hemolymph fills all of the interior hemocoel of the body and surrounds all
cells. Hemolymph is composed of water, inorganic salts (mostly sodium,
chlorine, potassium, magnesium, and calcium), and organic compounds
(mostly carbohydrates, proteins, and lipids). The primary oxygen transporter
molecule is hemocyanin.
There are free-floating cells, the hemocytes, within the hemolymph. They
play a role in the arthropod immune system.
Flatworms, such as this Pseudoceros bifurcus, lack specialized circulatory
organs
Above is a diagram of an open circulatory system. An open circulatory
system is made up of a heart, vessels, and hemolymph. This diagram shows
how the hemolymph, fluid present in most invertebrates that is equivalent to
blood, is circulated throughout the body of a grasshopper. The hymolymph is
first pumped through the heart, into the aorta, dispersed into the head and
throughout the hemocoel, then back through the ostium that are located in the
heart, where the process is repeated.
Absence of circulatory system
Circulatory systems are absent in some animals, including flatworms
(phylum Platyhelminthes). Their body cavity has no lining or enclosed fluid.
Instead a muscular pharynx leads to an extensively branched digestive
system that facilitates direct diffusion of nutrients to all cells. The flatworm's
dorso-ventrally flattened body shape also restricts the distance of any cell
from the digestive system or the exterior of the organism. Oxygen can diffuse
from the surrounding water into the cells, and carbon dioxide can diffuse out.
Consequently, every cell is able to obtain nutrients, water and oxygen
without the need of a transport system.
Some animals, such as jellyfish, have more extensive branching from their
gastrovascular cavity (which functions as both a place of digestion and a
form of circulation), this branching allows for bodily fluids to reach the outer
layers, since the digestion begins in the inner layers.
History
Human anatomical chart of blood vessels, with heart, lungs, liver and
kidneys included. Other organs are numbered and arranged around it. Before
cutting out the figures on this page, Vesalius suggests that readers glue the
page onto parchment and gives instructions on how to assemble the pieces
and paste the multilayered figure onto a base "muscle man" illustration.
"Epitome", fol.14a. HMD Collection, WZ 240 V575dhZ 1543.
The earliest known writings on the circulatory system are found in the Ebers
Papyrus (16th century BCE), an ancient Egyptian medical papyrus
containing over 700 prescriptions and remedies, both physical and spiritual.
In the papyrus, it acknowledges the connection of the heart to the arteries.
The Egyptians thought air came in through the mouth and into the lungs and
heart. From the heart, the air travelled to every member through the arteries.
Although this concept of the circulatory system is only partially correct, it
represents one of the earliest accounts of scientific thought.
In the 6th century BCE, the knowledge of circulation of vital fluids through
the body was known to the Ayurvedic physician Sushruta in ancient India.[15]
He also seems to have possessed knowledge of the arteries, described as
'channels' by Dwivedi & Dwivedi (2007).[15] The valves of the heart were
discovered by a physician of the Hippocratean school around the 4th century
BCE. However their function was not properly understood then. Because
blood pools in the veins after death, arteries look empty. Ancient anatomists
assumed they were filled with air and that they were for transport of air.
The Greek physician, Herophilus, distinguished veins from arteries but
thought that the pulse was a property of arteries themselves. Greek anatomist
Erasistratus observed that arteries that were cut during life bleed. He ascribed
the fact to the phenomenon that air escaping from an artery is replaced with
blood that entered by very small vessels between veins and arteries. Thus he
apparently postulated capillaries but with reversed flow of blood.[16]
In 2nd century AD Rome, the Greek physician Galen knew that blood vessels
carried blood and identified venous (dark red) and arterial (brighter and
thinner) blood, each with distinct and separate functions. Growth and energy
were derived from venous blood created in the liver from chyle, while
arterial blood gave vitality by containing pneuma (air) and originated in the
heart. Blood flowed from both creating organs to all parts of the body where
it was consumed and there was no return of blood to the heart or liver. The
heart did not pump blood around, the heart's motion sucked blood in during
diastole and the blood moved by the pulsation of the arteries themselves.
Galen believed that the arterial blood was created by venous blood passing
from the left ventricle to the right by passing through 'pores' in the
interventricular septum, air passed from the lungs via the pulmonary artery to
the left side of the heart. As the arterial blood was created 'sooty' vapors were
created and passed to the lungs also via the pulmonary artery to be exhaled.
In 1025, The Canon of Medicine by the Persian physician, Avicenna,
"erroneously accepted the Greek notion regarding the existence of a hole in
the ventricular septum by which the blood traveled between the ventricles."
Despite this, Avicenna "correctly wrote on the cardiac cycles and valvular
function", and "had a vision of blood circulation" in his Treatise on
Pulse.[17][verification needed] While also refining Galen's erroneous theory of the
pulse, Avicenna provided the first correct explanation of pulsation: "Every
beat of the pulse comprises two movements and two pauses. Thus,
expansion : pause : contraction : pause. [...] The pulse is a movement in the
heart and arteries ... which takes the form of alternate expansion and
contraction."[18]
In 1242, the Arabian physician, Ibn al-Nafis, became the first person to
accurately describe the process of pulmonary circulation, for which he is
sometimes considered the father of circulatory physiology.[19][not in citation given]
Ibn al-Nafis stated in his Commentary on Anatomy in Avicenna's Canon:
"...the blood from the right chamber of the heart must arrive at the left
chamber but there is no direct pathway between them. The thick septum of
the heart is not perforated and does not have visible pores as some people
thought or invisible pores as Galen thought. The blood from the right
chamber must flow through the vena arteriosa (pulmonary artery) to the
lungs, spread through its substances, be mingled there with air, pass through
the arteria venosa (pulmonary vein) to reach the left chamber of the heart and
there form the vital spirit..."
In addition, Ibn al-Nafis had an insight into what would become a larger
theory of the capillary circulation. He stated that "there must be small
communications or pores (manafidh in Arabic) between the pulmonary artery
and vein," a prediction that preceded the discovery of the capillary system by
more than 400 years.[20] Ibn al-Nafis' theory, however, was confined to blood
transit in the lungs and did not extend to the entire body.
Michael Servetus was the first European to describe the function of
pulmonary circulation, although his achievement was not widely recognized
at the time, for a few reasons. He firstly described it in the "Manuscript of
Paris"[21][22] (near 1546), but this work was never published. And later he
published this description, but in a theological treatise, Christianismi
Restitutio, not in a book on medicine. Only three copies of the book survived
but these remained hidden for decades, the rest were burned shortly after its Human digestive system
publication in 1553 because of persecution of Servetus by religious
authorities. Human digestive system

Better known discovery of pulmonary circulation was by Vesalius's

successor at Padua, Realdo Colombo, in 1559.

Image of veins from William Harvey's Exercitatio Anatomica de Motu

Cordis et Sanguinis in Animalibus

Finally, William Harvey, a pupil of Hieronymus Fabricius (who had earlier

described the valves of the veins without recognizing their function),
performed a sequence of experiments, and published Exercitatio Anatomica
de Motu Cordis et Sanguinis in Animalibus in 1628, which "demonstrated
that there had to be a direct connection between the venous and arterial
systems throughout the body, and not just the lungs. Most importantly, he
argued that the beat of the heart produced a continuous circulation of blood
through minute connections at the extremities of the body. This is a
conceptual leap that was quite different from Ibn al-Nafis' refinement of the
anatomy and bloodflow in the heart and lungs."[23] This work, with its
essentially correct exposition, slowly convinced the medical world. However,
Harvey was not able to identify the capillary system connecting arteries and
veins; these were later discovered by Marcello Malpighi in 1661.
In 1956, André Frédéric Cournand, Werner Forssmann and Dickinson W.
Richards were awarded the Nobel Prize in Medicine "for their discoveries
concerning heart catheterization and pathological changes in the circulatory
system."[24]
In the 1970s, Diana McSherry developed computer-based systems to create
images of the circulatory system and heart without the need for surgery.[25]
Human digestive system
The human digestive system consists of the gastrointestinal tract plus the
accessory organs of digestion (the tongue, salivary glands, pancreas, liver,
and gallbladder).[1] In this system, the process of digestion has many stages,
the first of which starts in the mouth. Digestion involves the breakdown of
food into smaller and smaller components, until they can be absorbed and
assimilated into the body.
Chewing, in which food is mixed with saliva begins the process of digestion.
This produces a bolus which can be swallowed down the esophagus and into
the stomach. Here it is mixed with gastric juice until it passes into the
duodenum, where it is mixed with a number of enzymes produced by the
pancreas. Saliva also contains a catalytic enzyme called amylase which starts
to act on food in the mouth. Another digestive enzyme called lingual lipase is
secreted by some of the lingual papillae on the tongue and also from serous
glands in the main salivary glands. Digestion is helped by the mastication of
food by the teeth and also by the muscular actions of peristalsis and
segmentation contractions. Gastric juice in the stomach is essential for the
continuation of digestion as is the production of mucus in the stomach.
Peristalsis is the rhythmic contraction of muscles that begins in the
esophagus and continues along the wall of the stomach and the rest of the
gastrointestinal tract. This initially results in the production of chyme which
when fully broken down in the small intestine is absorbed as chyle into the
lymphatic system. Most of the digestion of food takes place in the small
intestine. Water and some minerals are reabsorbed back into the blood in the
colon of the large intestine. The waste products of digestion (faeces) are
defecated from the anus via the rectum.
Components
Historical depiction of the digestive system, 17th century Persia
There are several organs and other components involved in the digestion of
food. The organs known as the accessory digestive glands are the liver, gall
bladder and pancreas. Other components include the mouth, salivary glands,
tongue, teeth and epiglottis.
The largest structure of the digestive system is the gastrointestinal tract (GI
tract). This starts at the mouth and ends at the anus, covering a distance of
about nine (9) metres.[2]
The largest part of the GI tract is the colon or large intestine. Water is
absorbed here and remaining waste matter is stored prior to defecation.[1]
Most of the digestion of food takes place in the small intestine.
A major digestive organ is the stomach. Within its mucosa are millions of
embedded gastric glands. Their secretions are vital to the functioning of the
organ.
There are many specialised cells of the GI tract. These include the various
cells of the gastric glands, taste cells, pancreatic duct cells, enterocytes and
microfold cells.
Some parts of the digestive system are also part of the excretory system.
Mouth
The mouth is the first part of the gastrointestinal tract and is equipped with
several structures that begin the first processes of digestion.[3] These include
salivary glands, teeth and the tongue. The mouth consists of two regions, the
vestibule and the oral cavity proper. The vestibule is the area between the
teeth, lips and cheeks,[4] and the rest is the oral cavity proper. Most of the oral
cavity is lined with oral mucosa, a mucous membrane that produces a
lubricating mucus, of which only a small amount is needed. Mucous
membranes vary in structure in the different regions of the body but they all
produce a lubricating mucus, which is either secreted by surface cells or
more usually by underlying glands. The mucous membrane in the mouth
continues as the thin mucosa which lines the bases of the teeth. The main
component of mucus is a glycoprotein called mucin and the type secreted
varies according to the region involved. Mucin is viscous, clear, and clinging.
Underlying the mucous membrane in the mouth is a thin layer of smooth
muscle tissue and the loose connection to the membrane gives it its great
elasticity.[5] It covers the cheeks, inner surfaces of the lips, and floor of the
mouth.[6]:1186
The roof of the mouth is termed the palate and it separates the oral cavity
from the nasal cavity. The palate is hard at the front of the mouth since the
overlying mucosa is covering a plate of bone; it is softer and more pliable at
the back being made of muscle and connective tissue, and it can move to
swallow food and liquids. The soft palate ends at the uvula.[7] The surface of
the hard palate allows for the pressure needed in eating food, to leave the
nasal passage clear.[8] The lips are the mouth's front boundary and the fauces
(the passageway between the tonsils, also called the throat),[6]:686 mark its
posterior boundary. At either side of the soft palate are the palatoglossus
muscles which also reach into regions of the tongue. These muscles raise the
back of the tongue and also close both sides of the fauces to enable food to
be swallowed.[6]:1208 Mucus helps in the mastication of food in its ability to
soften and collect the food in the formation of the bolus.
Salivary glands
Oral cavity
There are three pairs of main salivary glands and between 800 and 1,000
minor salivary glands, all of which mainly serve the digestive process, and
also play an important role in the maintenance of dental health and general
mouth lubrication, without which speech would be impossible.[9] The main
glands are all exocrine glands, secreting via ducts. All of these glands
terminate in the mouth. The largest of these are the parotid glands – their
secretion is mainly serous. The next pair are underneath the jaw, the
submandibular glands, these produce both serous fluid and mucus. The
serous fluid is produced by serous glands in these salivary glands which also
produce lingual lipase. They produce about 70% of the oral cavity saliva.
The third pair are the sublingual glands located underneath the tongue and
their secretion is mainly mucous with a small percentage of saliva.
Within the oral mucosa (a mucous membrane) lining the mouth and also on
the tongue and palates and mouth floor, are the minor salivary glands; their
secretions are mainly mucous and are innervated by the facial nerve (the
seventh cranial nerve).[10] The glands also secrete amylase a first stage in the
breakdown of food acting on the carbohydrate in the food to transform the
starch content into maltose. There are other glands on the surface of the
tongue that encircle taste buds on the back part of the tongue and these also
produce lingual lipase. Lipase is a digestive enzyme that catalyses the
hydrolysis of lipids (fats). These glands are termed Von Ebner's glands which
have also been shown to have another function in the secretion of histatins
which offer an early defense (outside of the immune system) against
microbes in food, when it makes contact with these glands on the tongue
tissue.[9][11] Sensory information can stimulate the secretion of saliva
providing the necessary fluid for the tongue to work with and also to ease
swallowing of the food.
Saliva
Main article: Saliva
Saliva functions initially in the digestive system to moisten and soften food
into the formation of a bolus. The bolus is further helped by the lubrication
provided by the saliva in its passage from the mouth into the esophagus. Also
of importance is the presence in saliva of the digestive enzymes amylase and
lipase. Amylase starts to work on the starch in carbohydrates, breaking it
down into the simple sugars of maltose and dextrose that can be further
broken down in the small intestine. Saliva in the mouth can account for 30%
of this initial starch digestion. Lipase starts to work on breaking down fats.
Lipase is further produced in the pancreas where it is released to continue
this digestion of fats. The presence of salivary lipase is of prime importance
in young babies whose pancreatic lipase has yet to be developed.[12]
As well as its role in supplying digestive enzymes, saliva has a cleansing
action for the teeth and mouth.[13] It also has an immunological role in
supplying antibodies to the system, such as immunoglobulin A.[14] This is
seen to be key in preventing infections of the salivary glands, importantly
that of parotitis.
Saliva also contains a glycoprotein called haptocorrin which is a binding
protein to vitamin B12.[15] It binds with the vitamin in order to carry it safely
through the acidic content of the stomach. When it reaches the duodenum,
pancreatic enzymes break down the glycoprotein and free the vitamin which
then binds with intrinsic factor.
Tongue
Food enters the mouth where the first stage in the digestive process takes
place, with the action of the tongue and the secretion of saliva. The tongue is
a fleshy and muscular sensory organ, and the very first sensory information is
received via the taste buds in the papillae on its surface. If the taste is
agreeable the tongue will go into action, manipulating the food in the mouth
which stimulates the secretion of saliva from the salivary glands. The liquid
quality of the saliva will help in the softening of the food and its enzyme
content will start to break down the food whilst it is still in the mouth. The
first part of the food to be broken down is the starch of carbohydrates (by the
enzyme amylase in the saliva).
The tongue is attached to the floor of the mouth by a ligamentous band called
the frenum[16] and this gives it great mobility for the manipulation of food
(and speech); the range of manipulation is optimally controlled by the action
of several muscles and limited in its external range by the stretch of the
frenum. The tongue's two sets of muscles, are four intrinsic muscles that
originate in the tongue and are involved with its shaping, and four extrinsic
muscles originating in bone that are involved with its movement.
Taste
Main article: Taste
Cross section of circumvallate papilla showing arrangement of nerves and
taste buds
Taste is a form of chemoreception that takes place in the specialised taste
receptors, contained in structures called taste buds in the mouth. Taste buds
are mainly on the upper surface (dorsum) of the tongue. The function of taste
perception is vital to help prevent harmful or rotten foods from being
consumed. There are also taste buds on the epiglottis and upper part of the
esophagus. The taste buds are innervated by a branch of the facial nerve the
chorda tympani, and the glossopharyngeal nerve. Taste messages are sent via
these cranial nerves to the brain. The brain can distinguish between the
chemical qualities of the food. The five basic tastes are referred to as those of
saltiness, sourness, bitterness, sweetness, and umami. The detection of
saltiness and sourness enables the control of salt and acid balance. The
detection of bitterness warns of poisons – many of a plant's defences are of
poisonous compounds that are bitter. Sweetness guides to those foods that
will supply energy; the initial breakdown of the energy-giving carbohydrates
by salivary amylase creates the taste of sweetness since simple sugars are the
first result. The taste of umami is thought to signal protein-rich food. Sour
tastes are acidic which is often found in bad food. The brain has to decide
very quickly whether the food should be eaten or not. It was the findings in
1991, describing the first olfactory receptors that helped to prompt the
research into taste. The olfactory receptors are located on cell surfaces in the
nose which bind to chemicals enabling the detection of smells. It is assumed
that signals from taste receptors work together with those from the nose, to
form an idea of complex food flavours.[17]
Teeth
Main article: Human teeth
Teeth are complex structures made of materials specific to them. They are
made of a bone-like material called dentin, which is covered by the hardest
tissue in the body—enamel.[18] Teeth have different shapes to deal with
different aspects of mastication employed in tearing and chewing pieces of
food into smaller and smaller pieces. This results in a much larger surface
area for the action of digestive enzymes. The teeth are named after their
particular roles in the process of mastication—incisors are used for cutting or
biting off pieces of food; canines, are used for tearing, premolars and molars
are used for chewing and grinding. Mastication of the food with the help of
saliva and mucus results in the formation of a soft bolus which can then be
swallowed to make its way down the upper gastrointestinal tract to the
stomach.[19] The digestive enzymes in saliva also help in keeping the teeth
clean by breaking down any lodged food particles.
Epiglottis
Main article: Epiglottis
The epiglottis is a flap that is made of elastic cartilage and attached to the
entrance of the larynx. It is covered with a mucous membrane and there are
taste buds on its lingual surface which faces into the mouth.[20] Its laryngeal
surface faces into the larynx. The epiglottis functions to guard the entrance of
the glottis, the opening between the vocal folds. It is normally pointed
upward during breathing with its underside functioning as part of the
pharynx, but during swallowing, the epiglottis folds down to a more
horizontal position, with its upper side functioning as part of the pharynx. In
this manner it prevents food from going into the trachea and instead directs it
to the esophagus, which is posterior. During swallowing, the backward
motion of the tongue forces the epiglottis over the glottis' opening to prevent
any food that is being swallowed from entering the larynx which leads to the
lungs; the larynx is also pulled upwards to assist this process. Stimulation of
the larynx by ingested matter produces a strong cough reflex in order to
protect the lungs.
Pharynx
Main article: Pharynx
The pharynx is a part of the conducting zone of the respiratory system and
also a part of the digestive system. It is the part of the throat immediately
behind the nasal cavity at the back of the mouth and above the esophagus and
larynx. The pharynx is made up of three parts. The lower two parts–the
oropharynx and the laryngopharynx are involved in the digestive system. The
laryngopharynx connects to the esophagus and it serves as a passageway for
both air and food. Air enters the larynx anteriorly but anything swallowed
has priority and the passage of air is temporarily blocked. The pharynx is
innervated by the pharyngeal plexus of the vagus nerve.[21] Muscles in the
pharynx push the food into the esophagus. The pharynx joins the esophagus
at the oesophageal inlet which is located behind the cricoid cartilage.
Esophagus
Main article: Esophagus
The esophagus commonly known as the gullet, is an organ which consists of
a muscular tube through which food passes from the pharynx to the stomach.
The esophagus is continuous with the laryngeal part of the pharynx. It passes
through the posterior mediastinum in the thorax and enters the stomach
through a hole in the thoracic diaphragm–the esophageal hiatus|, at the level
of the tenth thoracic vertebra (T10). Its length averages 25 cm, varying with
height. It is divided into cervical, thoracic and abdominal parts. The pharynx
joins the esophagus at the esophageal inlet which is behind the cricoid
cartilage.
At rest the esophagus is closed at both ends, by the upper and lower
esophageal sphincters. The opening of the upper sphincter is triggered by the
swallowing reflex so that food is allowed through. The sphincter also serves
to prevent back flow from the esophagus into the pharynx. The esophagus
has a mucous membrane and the epithelium which has a protective function
is continuously replaced due to the volume of food that passes inside the
esophagus. During swallowing, food passes from the mouth through the
pharynx into the esophagus. The epiglottis folds down to a more horizontal
position so as to prevent food from going into the trachea, instead directing it
to the esophagus.
Once in the esophagus, the bolus travels down to the stomach via rhythmic
contraction and relaxation of muscles known as peristalsis. The lower
esophageal sphincter is a muscular sphincter surrounding the lower part of
the esophagus. The junction between the esophagus and the stomach (the
gastroesophageal junction) is controlled by the lower esophageal sphincter,
which remains constricted at all times other than during swallowing and
vomiting to prevent the contents of the stomach from entering the esophagus.
As the esophagus does not have the same protection from acid as the
stomach, any failure of this sphincter can lead to heartburn. The esophagus
has a mucous membrane of epithelium which has a protective function as
well as providing a smooth surface for the passage of food. Due to the high
volume of food that is passed over time, this membrane is continuously
renewed.
Diaphragm
The diaphragm is an important part of the body's digestive system. The
diaphragm separates the thoracic cavity from the abdominal cavity where
most of the digestive organs are located. The suspensory muscle attaches the
ascending duodenum to the diaphragm. This muscle is thought to be of help
in the digestive system in that its attachment offers a wider angle to the
duodenojejunal flexure for the easier passage of digesting material. The
diaphragm also attaches to the bare area of the liver, which it anchors. The
esophagus enters the abdomen through a hole in the diaphragm at the level of
T10.
Stomach
Main article: Stomach
Areas of the stomach
The stomach is a major organ of the gastrointestinal tract and digestive
system. It is a consistently J-shaped organ joined to the esophagus at its
upper end and to the duodenum at its lower end. Gastric acid (informally
gastric juice), produced in the stomach plays a vital role in the digestive
process, and mainly contains hydrochloric acid and sodium chloride. A
peptide hormone, gastrin, produced by G cells in the gastric glands,
stimulates the production of gastric juice which activates the digestive
enzymes. Pepsinogen is a precursor enzyme (zymogen) produced by the
gastric chief cells, and gastric acid activates this to the enzyme pepsin which
begins the digestion of proteins. As these two chemicals would damage the
stomach wall, mucus is secreted by innumerable gastric glands in the
stomach, to provide a slimy protective layer against the damaging effects of
the chemicals.
At the same time that protein is being digested, mechanical churning occurs
through the action of peristalsis, waves of muscular contractions that move
along the stomach wall. This allows the mass of food to further mix with the
digestive enzymes. Gastric lipase secreted by the chief cells in the fundic
glands in the gastric mucosa of the stomach, is an acidic lipase, in contrast
with the alkaline pancreatic lipase. This breaks down fats to some degree
though is not as efficient as the pancreatic lipase.
The pylorus, the lowest section of the stomach which attaches to the
duodenum via the pyloric canal, contains countless glands which secrete
digestive enzymes including gastrin. After an hour or two, a thick semi-liquid
called chyme is produced. When the pyloric sphincter, or valve opens, chyme
enters the duodenum where it mixes further with digestive enzymes from the
pancreas, and then passes through the small intestine, where digestion
continues. When the chyme is fully digested, it is absorbed into the blood.
95% of absorption of nutrients occurs in the small intestine. Water and
minerals are reabsorbed back into the blood in the colon of the large
intestine, where the environment is slightly acidic. Some vitamins, such as
biotin and vitamin K produced by bacteria in the gut flora of the colon are
also absorbed.

The parietal cells in the fundus of the stomach, produce a glycoprotein called
intrinsic factor which is essential for the absorption of vitamin B12. Vitamin
B12 (cobalamin), is carried to, and through the stomach, bound to a
glycoprotein secreted by the salivary glands - transcobalamin I also called
haptocorrin, which protects the acid-sensitive vitamin from the acidic
stomach contents. Once in the more neutral duodenum, pancreatic enzymes
break down the protective glycoprotein. The freed vitamin B12 then binds to
intrinsic factor which is then absorbed by the enterocytes in the ileum.

The stomach is a distensible organ and can normally expand to hold about
one litre of food.[22] This expansion is enabled by a series of gastric folds in
the inner walls of the stomach. The stomach of a newborn baby will only be
able to expand to retain about 30 ml.

Spleen
Main article: Spleen
The spleen breaks down both red and white blood cells that are spent. This is
why it is sometimes known as the 'graveyard of red blood cells'. A product of
this digestion is the pigment bilirubin, which is sent to the liver and secreted
in the bile. Another product is iron, which is used in the formation of new
blood cells in the bone marrow.[5] Medicine treats the spleen solely as
belonging to the lymphatic system, though it is acknowledged that the full
range of its important functions is not yet understood.[23]
Liver
Main article: Liver
The liver is the second largest organ (after the skin) and is an accessory
digestive gland which plays a role in the body's metabolism. The liver has
many functions some of which are important to digestion. The liver can
detoxify various metabolites; synthesise proteins and produce biochemicals
needed for digestion. It regulates the storage of glycogen which it can form
from glucose (glycogenesis). The liver can also synthesise glucose from
certain amino acids. Its digestive functions are largely involved with the
breaking down of carbohydrates. It also maintains protein metabolism in its
synthesis and degradation. In lipid metabolism it synthesises cholesterol. Fats
are also produced in the process of lipogenesis. The liver synthesises the bulk
of lipoproteins. The liver is located in the upper right quadrant of the
abdomen and below the diaphragm to which it is attached at one part, This is
to the right of the stomach and it overlies the gall bladder. The liver produces
bile, an important alkaline compound which aids digestion.
Bile

Bile produced by the liver is made up of water (97%), bile salts, mucus and
pigments, 1% fats and inorganic salts.[24] Bilirubin is its major pigment. Bile
acts partly as a surfactant which lowers the surface tension between either
two liquids or a solid and a liquid and helps to emulsify the fats in the chyme.
Food fat is dispersed by the action of bile into smaller units called micelles.
The breaking down into micelles creates a much larger surface area for the
pancreatic enzyme, lipase to work on. Lipase digests the triglycerides which Main article: Pancreas
are broken down into two fatty acids and a monoglyceride. These are then
absorbed by villi on the intestinal wall. If fats are not absorbed in this way in
the small intestine problems can arise later in the large intestine which is not
equipped to absorb fats. Bile also helps in the absorption of vitamin K from
the diet. Bile is collected and delivered through the common hepatic duct.
This duct joins with the cystic duct to connect in a common bile duct with the
gallbladder. Bile is stored in the gallbladder for release when food is
discharged into the duodenum and also after a few hours.[25]

Gallbladder
Action of digestive hormones
The gallbladder is a hollow part of the biliary system that sits just beneath the
liver, with the gallbladder body resting in a small depression.[26] It is a small
organ where the bile produced by the liver is stored, before being released
into the small intestine. Bile flows from the liver through the bile ducts and
into the gall bladder for storage. The bile is released in response to
cholecystokinin (CKK) a peptide hormone released from the duodenum. The
production of CKK (by endocrine cells of the duodenum) is stimulated by the
presence of fat in the duodenum.[27]

It is divided into three sections, a fundus, body and neck. The neck tapers and
connects to the biliary tree via the cystic duct, which then joins the common
hepatic duct to form the common bile duct. At this junction is a mucosal fold
called Hartmann's pouch, where gallstones commonly get stuck. The
muscular layer of the body is of smooth muscle tissue that helps the
gallbladder contract, so that it can discharge its bile into the bile duct. The
gallbladder needs to store bile in a natural, semi-liquid form at all times.
Hydrogen ions secreted from the inner lining of the gallbladder keep the bile
acidic enough to prevent hardening. To dilute the bile, water and electrolytes
from the digestion system are added. Also, salts attach themselves to
cholesterol molecules in the bile to keep them from crystallising. If there is
too much cholesterol or bilirubin in the bile, or if the gallbladder doesn't
empty properly the systems can fail. This is how gallstones form when a
small piece of calcium gets coated with either cholesterol or bilirubin and the
bile crystallises and forms a gallstone. The main purpose of the gallbladder is
to store and release bile, or gall. Bile is released into the small intestine in
order to help in the digestion of fats by breaking down larger molecules into
smaller ones. After the fat is absorbed, the bile is also absorbed and
transported back to the liver for reuse.
Pancreas
Pancreas, duodenum and bile duct
The pancreas is a major organ functioning as an accessory digestive gland in
the digestive system. It is both an endocrine gland and an exocrine gland.[28]
The endocrine part secretes insulin when the blood sugar becomes high;
insulin moves glucose from the blood into the muscles and other tissues for
use as energy. The endocrine part releases glucagon when the blood sugar is
low; glucagon allows stored sugar to be broken down into glucose by the
liver in order to re–balance the sugar levels. The pancreas produces and
releases important digestive enzymes in the pancreatic juice that it delivers to
the duodenum. The pancreas lies below and at the back of the stomach. It
connects to the duodenum via the pancreatic duct which it joins near to the
bile duct's connection where both the bile and pancreatic juice can act on the
chyme that is released from the stomach into the duodenum. Aqueous
pancreatic secretions from pancreatic duct cells contain bicarbonate ions
which are alkaline and help with the bile to neutralise the acidic chyme that
is churned out by the stomach.
The pancreas is also the main source of enzymes for the digestion of fats and
proteins. Some of these are released in response to the production of CKK in
the duodenum. (The enzymes that digest polysaccharides, by contrast, are
primarily produced by the walls of the intestines.) The cells are filled with
secretory granules containing the precursor digestive enzymes. The major
proteases, the pancreatic enzymes which work on proteins, are trypsinogen
and chymotrypsinogen. Elastase is also produced. Smaller amounts of lipase
and amylase are secreted. The pancreas also secretes phospholipase A2, Duodenum
lysophospholipase, and cholesterol esterase. The precursor zymogens, are
inactive variants of the enzymes; which avoids the onset of pancreatitis
Food starts to arrive in the small intestine one hour after it is eaten, and after
caused by autodegradation. Once released in the intestine, the enzyme
two hours the stomach has emptied. Until this time the food is termed a
enteropeptidase present in the intestinal mucosa activates trypsinogen by
bolus. It then becomes the partially digested semi-liquid termed chyme.
cleaving it to form trypsin; further cleavage results in chymotripsin.
In the small intestine, the pH becomes crucial; it needs to be finely balanced
Lower gastrointestinal tract
in order to activate digestive enzymes. The chyme is very acidic, with a low
pH, having been released from the stomach and needs to be made much more
Main article: Human gastrointestinal tract alkaline. This is achieved in the duodenum by the addition of bile from the
gall bladder combined with the bicarbonate secretions from the pancreatic
The lower gastrointestinal tract (GI), includes the small intestine and all of duct and also from secretions of bicarbonate-rich mucus from duodenal
the large intestine.[29] The intestine is also called the bowel or the gut. The glands known as Brunner's glands. The chyme arrives in the intestines having
lower GI starts at the pyloric sphincter of the stomach and finishes at the been released from the stomach through the opening of the pyloric sphincter.
anus. The small intestine is subdivided into the duodenum, the jejunum and The resulting alkaline fluid mix neutralises the gastric acid which would
the ileum. The cecum marks the division between the small and large damage the lining of the intestine. The mucus component lubricates the walls
intestine. The large intestine includes the rectum and anal canal.[1] of the intestine.

Small intestine When the digested food particles are reduced enough in size and
composition, they can be absorbed by the intestinal wall and carried to the
bloodstream. The first receptacle for this chyme is the duodenal bulb. From
here it passes into the first of the three sections of the small intestine, the
duodenum. (The next section is the jejunum and the third is the ileum). The
duodenum is the first and shortest section of the small intestine. It is a
hollow, jointed C-shaped tube connecting the stomach to the jejunum. It
starts at the duodenal bulb and ends at the suspensory muscle of duodenum.
The attachment of the suspensory muscle to the diaphragm is thought to help
the passage of food by making a wider angle at its attachment.

Most food digestion takes place in the small intestine. Segmentation

contractions act to mix and move the chyme more slowly in the small
intestine allowing more time for absorption (and these continue in the large
intestine). In the duodenum, pancreatic lipase is secreted together with a co-
Lower GI tract - 3) Small intestine; 5) Cecum; 6) Large intestine enzyme, colipase to further digest the fat content of the chyme. From this
breakdown, smaller particles of emulsified fats called chylomicrons are
produced. There are also digestive cells called enterocytes lining the
intestines (the majority being in the small intestine). They are unusual cells in
that they have villi on their surface which in turn have innumerable
microvilli on their surface. All these villi make for a greater surface area, not
only for the absorption of chyme but also for its further digestion by large
numbers of digestive enzymes present on the microvilli.
The chylomicrons are small enough to pass through the enterocyte villi and
into their lymph capillaries called lacteals. A milky fluid called chyle,
consisting mainly of the emulsified fats of the chylomicrons, results from the
absorbed mix with the lymph in the lacteals.[clarification needed] Chyle is then
transported through the lymphatic system to the rest of the body.
The suspensory muscle marks the end of the duodenum and the division
between the upper gastrointestinal tract and the lower GI tract. The digestive
tract continues as the jejunum which continues as the ileum. The jejunum,
the midsection of the small intestine contains circular folds, flaps of doubled
mucosal membrane which partially encircle and sometimes completely
encircle the lumen of the intestine. These folds together with villi serve to
increase the surface area of the jejunum enabling an increased absorption of
digested sugars, amino acids and fatty acids into the bloodstream. The
circular folds also slow the passage of food giving more time for nutrients to
be absorbed.
The last part of the small intestine is the ileum. This also contains villi and
vitamin B12; bile acids and any residue nutrients are absorbed here. When
the chyme is exhausted of its nutrients the remaining waste material changes
into the semi-solids called feces, which pass to the large intestine, where
bacteria in the gut flora further break down residual proteins and starches.[30]
Cecum
Cecum and beginning of ascending colon
The cecum is a pouch marking the division between the small intestine and
the large intestine.[31] The cecum receives chyme from the last part of the
small intestine, the ileum, and connects to the ascending colon of the large
intestine. At this junction there is a sphincter or valve, the ileocecal valve
which slows the passage of chyme from the ileum, allowing further
digestion. It is also the site of the appendix attachment.
Large intestine
In the large intestine,[1] the passage of the digesting food in the colon is a lot
slower, taking from 12 to 50 hours until it is removed by defecation. The
colon mainly serves as a site for the fermentation of digestible matter by the
gut flora. The time taken varies considerably between individuals. The
remaining semi-solid waste is termed feces and is removed by the
coordinated contractions of the intestinal walls, termed peristalsis, which
propels the excreta forward to reach the rectum and exit via defecation from
the anus. The wall has an outer layer of longitudinal muscles, the taeniae
coli, and an inner layer of circular muscles. The circular muscle keeps the
material moving forward and also prevents any back flow of waste. Also of
help in the action of peristalsis is the basal electrical rhythm that determines
the frequency of contractions.[32] The taeniae coli can be seen and are
responsible for the bulges (haustra) present in the colon. Most parts of the GI
tract are covered with serous membranes and have a mesentery. Other more
muscular parts are lined with adventitia.
Blood supply
Blood supply to the digestive organs[33]
Arteries and veins around the pancreas and spleen
The digestive system is supplied by the celiac artery. The celiac artery is the
first major branch from the abdominal aorta, and is the only major artery that
nourishes the digestive organs.
There are three main divisions – the left gastric artery, the common hepatic
artery and the splenic artery.
The celiac artery supplies the liver, stomach, spleen and the upper 1/3 of the
duodenum (to the sphincter of Oddi) and the pancreas with oxygenated
blood. Most of the blood is returned to the liver via the portal venous system
for further processing and detoxification before returning to the systemic
circulation via the hepatic portal vein.
The next branch from the abdominal aorta is the superior mesenteric artery,
which supplies the regions of the digestive tract derived from the midgut,
which includes the distal 2/3 of the duodenum, jejunum, ileum, cecum,
appendix, ascending colon, and the proximal 2/3 of the transverse colon.
The final branch which is important for the digestive system is the inferior
mesenteric artery, which supplies the regions of the digestive tract derived
from the hindgut, which includes the distal 1/3 of the transverse colon,
descending colon, sigmoid colon, rectum, and the anus above the pectinate
line.
Nerve supply
Dietary life rules, Japan, Edo period.
The enteric nervous system consists of some one hundred million neurons[34]
that are embedded in the peritoneum, the lining of the gastrointestinal tract
extending from the esophagus to the anus.[35] These neurons are collected
into two plexuses - the myenteric (or Auerbach's) plexus that lies between the
longitudinal and the smooth muscle layers, and the submucosal (or
Meissner's) plexus that lies between the circular smooth muscle layer and the
mucosa.[36][37][38]
Parasympathetic innervation to the ascending colon is supplied by the vagus
nerve. Sympathetic innervation is supplied by the splanchnic nerves that join
the celiac ganglia. Most of the digestive tract is innervated by the two large
celiac ganglia, with the upper part of each ganglion joined by the greater
splanchnic nerve and the lower parts joined by the lesser splanchnic nerve. It
is from these ganglia that many of the gastric plexuses arise.
Clinical significance
Main article: Gastrointestinal disease
Each part of the digestive system is subject to a wide range of disorders
many of which can be congenital. Mouth diseases can also be caused by
pathogenic bacteria, viruses and fungi. Mouth diseases include tongue
diseases and salivary gland diseases. A common gum disease in the mouth is
gingivitis which is caused by bacteria in plaque. The most common viral
infection of the mouth is gingivostomatitis caused by herpes simplex. A
common fungal infection is candidiasis commonly known as thrush which
affects the mucous membranes of the mouth.
There are a number of esophageal diseases such as the development of
Schatzki rings that can restrict the passageway, causing difficulties in
swallowing. They can also completely block the esophagus.[39]
Stomach diseases are often chronic conditions and include gastroparesis,
gastritis, and peptic ulcers.
A number of problems including malnutrition and anemia can arise from
malabsorption, the abnormal absorption of nutrients in the GI tract.
Malabsorption can have many causes ranging from infection, to enzyme
deficiencies such as exocrine pancreatic insufficiency. It can also arise as a
result of other gastrointestinal diseases such as coeliac disease. Coeliac
disease is an autoimmune disorder of the small intestine. This can cause
vitamin deficiencies due to the improper absorption of nutrients in the small
intestine. The small intestine can also be obstructed by a volvulus, a loop of
intestine that becomes twisted enclosing its attached mesentery. This can
cause mesenteric ischemia if severe enough.
A common disorder of the bowel is diverticulitis. Diverticula are small
pouches that can form inside the bowel wall, which can become inflamed to
give diverticulitis. This disease can have complications if an inflamed
diverticulum bursts and infection sets in. Any infection can spread further to
the lining of the abdomen (peritoneum) and cause potentially fatal
peritonitis.[40]
Crohn's disease is a common chronic inflammatory bowel disease (IBD),
which can affect any part of the GI tract,[41] but it mostly starts in the terminal
ileum.
In pregnancy
Gestation can predispose for certain digestive disorders. Gestational diabetes
can develop in the mother as a result of pregnancy and while this often
presents with few symptoms it can lead to pre-eclampsia.
Digestion
From Wikipedia, the free encyclopedia
For the industrial process, see anaerobic digestion. For the treatment of
precipitates in analytical chemistry, see Precipitation (chemistry)
§ Digestion.
Digestive system

Ulcerative colitis an ulcerative form of colitis, is the other major

inflammatory bowel disease which is restricted to the colon and rectum. Both
of these IBDs can give an increased risk of the development of colorectal
cancer. Ulcerative coliltis is the most common of the IBDs[42]

Irritable bowel syndrome (IBS) is the most common of the functional

gastrointestinal disorders. These are idiopathic disorders that the Rome
process has helped to define.[43]

Giardiasis is a disease of the small intestine caused by a protist parasite

Giardia lamblia. This does not spread but remains confined to the lumen of
the small intestine.[44] It can often be asymptomatic, but as often can be
indicated by a variety of symptoms. Giardiasis is the most common
pathogenic parasitic infection in humans.[45] Details

There are diagnostic tools mostly involving the ingestion of barium sulphate
to investigate disorders of the GI tract.[46] These are known as upper
gastrointestinal series that enable imaging of the pharynx, larynx,
oesophagous, stomach and small intestine and lower gastrointestinal series
for imaging of the colon.
Digestion is the breakdown of large insoluble food molecules into small
water-soluble food molecules so that they can be absorbed into the watery
blood plasma. In certain organisms, these smaller substances are absorbed
through the small intestine into the blood stream. Digestion is a form of
catabolism that is often divided into two processes based on how food is
broken down: mechanical and chemical digestion. The term mechanical
digestion refers to the physical breakdown of large pieces of food into
smaller pieces which can subsequently be accessed by digestive enzymes. In
chemical digestion, enzymes break down food into the small molecules the
body can use.
In the human digestive system, food enters the mouth and mechanical Some organisms, including nearly all spiders, simply secrete biotoxins and
digestion of the food starts by the action of mastication (chewing), a form of digestive chemicals (e.g., enzymes) into the extracellular environment prior
mechanical digestion, and the wetting contact of saliva. Saliva, a liquid to ingestion of the consequent "soup". In others, once potential nutrients or
secreted by the salivary glands, contains salivary amylase, an enzyme which food is inside the organism, digestion can be conducted to a vesicle or a sac-
starts the digestion of starch in the food; the saliva also contains mucus, like structure, through a tube, or through several specialized organs aimed at
which lubricates the food, and hydrogen carbonate, which provides the ideal making the absorption of nutrients more efficient.
conditions of pH (alkaline) for amylase to work. After undergoing
mastication and starch digestion, the food will be in the form of a small,
round slurry mass called a bolus. It will then travel down the esophagus and
into the stomach by the action of peristalsis. Gastric juice in the stomach
starts protein digestion. Gastric juice mainly contains hydrochloric acid and
pepsin. As these two chemicals may damage the stomach wall, mucus is
secreted by the stomach, providing a slimy layer that acts as a shield against
the damaging effects of the chemicals. At the same time protein digestion is
occurring, mechanical mixing occurs by peristalsis, which is waves of
muscular contractions that move along the stomach wall. This allows the
mass of food to further mix with the digestive enzymes.

After some time (typically 1–2 hours in humans, 4–6 hours in dogs, 3–4
hours in house cats),[citation needed] the resulting thick liquid is called chyme.
When the pyloric sphincter valve opens, chyme enters the duodenum where
it mixes with digestive enzymes from the pancreas and bile juice from the
liver and then passes through the small intestine, in which digestion
continues. When the chyme is fully digested, it is absorbed into the blood.
95% of absorption of nutrients occurs in the small intestine. Water and
minerals are reabsorbed back into the blood in the colon (large intestine)
where the pH is slightly acidic about 5.6 ~ 6.9. Some vitamins, such as biotin
and vitamin K (K2MK7) produced by bacteria in the colon are also absorbed
into the blood in the colon. Waste material is eliminated from the rectum
during defecation.[1]
Digestive system
Digestive systems take many forms. There is a fundamental distinction
between internal and external digestion. External digestion developed earlier
in evolutionary history, and most fungi still rely on it.[2] In this process,
enzymes are secreted into the environment surrounding the organism, where
they break down an organic material, and some of the products diffuse back
to the organism. Animals have a tube (gastrointestinal tract) in which internal
digestion occurs, which is more efficient because more of the broken down
products can be captured, and the internal chemical environment can be more
efficiently controlled.[3]
Schematic drawing of bacterial conjugation. 1- Donor cell produces pilus. 2-
Pilus attaches to recipient cell, bringing the two cells together. 3- The mobile
plasmid is nicked and a single strand of DNA is transferred to the recipient
cell. 4- Both cells recircularize their plasmids, synthesize second strands, and
reproduce pili; both cells are now viable donors.
Secretion systems
Main article: Secretion
Bacteria use several systems to obtain nutrients from other organisms in the
environments.
Channel transport system
In a channel transupport system, several proteins form a contiguous channel
traversing the inner and outer membranes of the bacteria. It is a simple
system, which consists of only three protein subunits: the ABC protein,
membrane fusion protein (MFP), and outer membrane protein (OMP)[specify].
This secretion system transports various molecules, from ions, drugs, to
proteins of various sizes (20 – 900 kDa). The molecules secreted vary in size
from the small Escherichia coli peptide colicin V, (10 kDa) to the
Pseudomonas fluorescens cell adhesion protein LapA of 900 kDa.[4]
Molecular syringe

One molecular syringe is used through which a bacterium (e.g. certain types
of Salmonella, Shigella, Yersinia) can inject nutrients into protist cells. One
such mechanism was first discovered in Y. pestis and showed that toxins
could be injected directly from the bacterial cytoplasm into the cytoplasm of
its host's cells rather than simply be secreted into the extracellular medium.[5]

Conjugation machinery Venus Flytrap (Dionaea muscipula) leaf

The conjugation machinery of some bacteria (and archaeal flagella) is
capable of transporting both DNA and proteins. It was discovered in
Agrobacterium tumefaciens, which uses this system to introduce the Ti
plasmid and proteins into the host, which develops the crown gall (tumor).[6]
The VirB complex of Agrobacterium tumefaciens is the prototypic system.[7]
The nitrogen fixing Rhizobia are an interesting case, wherein conjugative
elements naturally engage in inter-kingdom conjugation. Such elements as
the Agrobacterium Ti or Ri plasmids contain elements that can transfer to
plant cells. Transferred genes enter the plant cell nucleus and effectively
transform the plant cells into factories for the production of opines, which the
bacteria use as carbon and energy sources. Infected plant cells form crown
gall or root tumors. The Ti and Ri plasmids are thus endosymbionts of the
bacteria, which are in turn endosymbionts (or parasites) of the infected plant.
The Ti and Ri plasmids are themselves conjugative. Ti and Ri transfer
between bacteria uses an independent system (the tra, or transfer, operon)
from that for inter-kingdom transfer (the vir, or virulence, operon). Such
transfer creates virulent strains from previously avirulent Agrobacteria.
Gastrovascular cavity
The gastrovascular cavity functions as a stomach in both digestion and the
distribution of nutrients to all parts of the body. Extracellular digestion takes
place within this central cavity, which is lined with the gastrodermis, the
internal layer of epithelium. This cavity has only one opening to the outside
that functions as both a mouth and an anus: waste and undigested matter is
excreted through the mouth/anus, which can be described as an incomplete
gut.
In a plant such as the Venus Flytrap that can make its own food through
photosynthesis, it does not eat and digest its prey for the traditional
objectives of harvesting energy and carbon, but mines prey primarily for
essential nutrients (nitrogen and phosphorus in particular) that are in short
supply in its boggy, acidic habitat.[11]

Release of outer membrane vesicles

In addition to the use of the multiprotein complexes listed above, Gram-
negative bacteria possess another method for release of material: the
formation of outer membrane vesicles.[8][9] Portions of the outer membrane
pinch off, forming spherical structures made of a lipid bilayer enclosing
periplasmic materials. Vesicles from a number of bacterial species have been
found to contain virulence factors, some have immunomodulatory effects,
and some can directly adhere to and intoxicate host cells. While release of
vesicles has been demonstrated as a general response to stress conditions, the
process of loading cargo proteins seems to be selective.[10]
Trophozoites of Entamoeba histolytica with ingested erythrocytes
Phagosome
A phagosome is a vacuole formed around a particle absorbed by
phagocytosis. The vacuole is formed by the fusion of the cell membrane
around the particle. A phagosome is a cellular compartment in which
pathogenic microorganisms can be killed and digested. Phagosomes fuse
with lysosomes in their maturation process, forming phagolysosomes. In
humans, Entamoeba histolytica can phagocytose red blood cells.[12]
Specialised organs and behaviours
To aid in the digestion of their food animals evolved organs such as beaks,
tongues, teeth, a crop, gizzard, and others.
A Catalina Macaw's seed-shearing beak
Squid beak with ruler for size comparison
Beaks
Birds have bony beaks that are specialised according to the bird's ecological
niche. For example, macaws primarily eat seeds, nuts, and fruit, using their
impressive beaks to open even the toughest seed. First they scratch a thin line
with the sharp point of the beak, then they shear the seed open with the sides
of the beak.
The mouth of the squid is equipped with a sharp horny beak mainly made of
cross-linked proteins. It is used to kill and tear prey into manageable pieces.
The beak is very robust, but does not contain any minerals, unlike the teeth
and jaws of many other organisms, including marine species.[13] The beak is
the only indigestible part of the squid.
Tongue
Main article: Tongue
The tongue is skeletal muscle on the floor of the mouth that manipulates
food for chewing (mastication) and swallowing (deglutition). It is sensitive
and kept moist by saliva. The underside of the tongue is covered with a
smooth mucous membrane. The tongue also has a touch sense for locating
and positioning food particles that require further chewing. The tongue is
utilized to roll food particles into a bolus before being transported down the
esophagus through peristalsis.
The sublingual region underneath the front of the tongue is a location where
the oral mucosa is very thin, and underlain by a plexus of veins. This is an
ideal location for introducing certain medications to the body. The sublingual
route takes advantage of the highly vascular quality of the oral cavity, and
allows for the speedy application of medication into the cardiovascular
system, bypassing the gastrointestinal tract.
Teeth
Main article: Teeth
Teeth (singular tooth) are small whitish structures found in the jaws (or
mouths) of many vertebrates that are used to tear, scrape, milk and chew
food. Teeth are not made of bone, but rather of tissues of varying density and
hardness, such as enamel, dentine and cementum. Human teeth have a blood
and nerve supply which enables proprioception. This is the ability of
sensation when chewing, for example if we were to bite into something too
hard for our teeth, such as a chipped plate mixed in food, our teeth send a
message to our brain and we realise that it cannot be chewed, so we stop
trying.
The shapes, sizes and numbers of types of animals' teeth are related to their
diets. For example, herbivores have a number of molars which are used to
grind plant matter, which is difficult to digest. Carnivores have canine teeth
which are used to kill and tear meat.
Crop
A crop, or croup, is a thin-walled expanded portion of the alimentary tract
used for the storage of food prior to digestion. In some birds it is an
expanded, muscular pouch near the gullet or throat. In adult doves and
pigeons, the crop can produce crop milk to feed newly hatched birds.[14]
Certain insects may have a crop or enlarged esophagus.
Rough illustration of a ruminant digestive system
Abomasum
Main article: Abomasum
Herbivores have evolved cecums (or an abomasum in the case of ruminants).
Ruminants have a fore-stomach with four chambers. These are the rumen,
reticulum, omasum, and abomasum. In the first two chambers, the rumen and
the reticulum, the food is mixed with saliva and separates into layers of solid
and liquid material. Solids clump together to form the cud (or bolus). The
cud is then regurgitated, chewed slowly to completely mix it with saliva and
to break down the particle size.
Fibre, especially cellulose and hemi-cellulose, is primarily broken down into
the volatile fatty acids, acetic acid, propionic acid and butyric acid in these
chambers (the reticulo-rumen) by microbes: (bacteria, protozoa, and fungi).
In the omasum, water and many of the inorganic mineral elements are
absorbed into the blood stream.
The abomasum is the fourth and final stomach compartment in ruminants. It
is a close equivalent of a monogastric stomach (e.g., those in humans or
pigs), and digesta is processed here in much the same way. It serves
primarily as a site for acid hydrolysis of microbial and dietary protein,
preparing these protein sources for further digestion and absorption in the
small intestine. Digesta is finally moved into the small intestine, where the
digestion and absorption of nutrients occurs. Microbes produced in the
reticulo-rumen are also digested in the small intestine.
A flesh fly "blowing a bubble", possibly to concentrate its food by
evaporating water
Specialised behaviours
Regurgitation has been mentioned above under abomasum and crop,
referring to crop milk, a secretion from the lining of the crop of pigeons and
doves with which the parents feed their young by regurgitation.[15]
Many sharks have the ability to turn their stomachs inside out and evert it out
of their mouths in order to get rid of unwanted contents (perhaps developed
as a way to reduce exposure to toxins).
Other animals, such as rabbits and rodents, practise coprophagia behaviours
– eating specialised faeces in order to re-digest food, especially in the case of
roughage. Capybara, rabbits, hamsters and other related species do not have a
complex digestive system as do, for example, ruminants. Instead they extract
more nutrition from grass by giving their food a second pass through the gut.
Soft faecal pellets of partially digested food are excreted and generally
consumed immediately. They also produce normal droppings, which are not
eaten.
Young elephants, pandas, koalas, and hippos eat the faeces of their mother,
probably to obtain the bacteria required to properly digest vegetation. When
they are born, their intestines do not contain these bacteria (they are
completely sterile). Without them, they would be unable to get any
nutritional value from many plant components.
In earthworms
An earthworm's digestive system consists of a mouth, pharynx, esophagus,
crop, gizzard, and intestine. The mouth is surrounded by strong lips, which
act like a hand to grab pieces of dead grass, leaves, and weeds, with bits of
soil to help chew. The lips break the food down into smaller pieces. In the
pharynx, the food is lubricated by mucus secretions for easier passage. The
esophagus adds calcium carbonate to neutralize the acids formed by food
matter decay. Temporary storage occurs in the crop where food and calcium
carbonate are mixed. The powerful muscles of the gizzard churn and mix the
mass of food and dirt. When the churning is complete, the glands in the walls
of the gizzard add enzymes to the thick paste, which helps chemically
breakdown the organic matter. By peristalsis, the mixture is sent to the
intestine where friendly bacteria continue chemical breakdown. This releases
carbohydrates, protein, fat, and various vitamins and minerals for absorption
into the body.
Overview of vertebrate digestion
In mammals, preparation for digestion begins with the cephalic phase in
which saliva is produced in the mouth and digestive enzymes are produced in
the stomach. Mechanical and chemical digestion begin in the mouth where
food is chewed, and mixed with saliva to begin enzymatic processing of
starches. The stomach continues to break food down mechanically and
chemically through churning and mixing with both acids and enzymes.
Absorption occurs in the stomach and gastrointestinal tract, and the process
finishes with defecation.[1]
Human digestion process
Main article: Human digestive system

In most vertebrates, digestion is a multistage process in the digestive system,

starting from ingestion of raw materials, most often other organisms.
Ingestion usually involves some type of mechanical and chemical processing.
Digestion is separated into four steps:

1. Ingestion: placing food into the mouth (entry of food in the digestive
system),
2. Mechanical and chemical breakdown: mastication and the mixing of
the resulting bolus with water, acids, bile and enzymes in the
stomach and intestine to break down complex molecules into simple
structures,
3. Absorption: of nutrients from the digestive system to the circulatory
and lymphatic capillaries through osmosis, active transport, and
diffusion, and
4. Egestion (Excretion): Removal of undigested materials from the
digestive tract through defecation.

Underlying the process is muscle movement throughout the system through

swallowing and peristalsis. Each step in digestion requires energy, and thus
imposes an "overhead charge" on the energy made available from absorbed
substances. Differences in that overhead cost are important influences on
lifestyle, behavior, and even physical structures. Examples may be seen in
humans, who differ considerably from other hominids (lack of hair, smaller
jaws and musculature, different dentition, length of intestines, cooking, etc.).

The major part of digestion takes place in the small intestine. The large
intestine primarily serves as a site for fermentation of indigestible matter by Upper and Lower human gastrointestinal tract
gut bacteria and for resorption of water from digests before excretion.
The human gastrointestinal tract is around 9 meters long. Food digestion
physiology varies between individuals and upon other factors such as the
characteristics of the food and size of the meal, and the process of digestion
normally takes between 24 and 72 hours.[16]
Different phases of digestion take place including: the cephalic phase,
gastric phase, and intestinal phase. The cephalic phase occurs at the sight,
thought and smell of food, which stimulate the cerebral cortex. Taste and
smell stimuli are sent to the hypothalamus and medulla oblongata. After this
it is routed through the vagus nerve and release of acetylcholine. Gastric
secretion at this phase rises to 40% of maximum rate. Acidity in the stomach
is not buffered by food at this point and thus acts to inhibit parietal (secretes
acid) and G cell (secretes gastrin) activity via D cell secretion of
somatostatin. The gastric phase takes 3 to 4 hours. It is stimulated by
distension of the stomach, presence of food in stomach and decrease in pH.
Distention activates long and myenteric reflexes. This activates the release of
acetylcholine, which stimulates the release of more gastric juices. As protein
enters the stomach, it binds to hydrogen ions, which raises the pH of the
stomach. Inhibition of gastrin and gastric acid secretion is lifted. This triggers
G cells to release gastrin, which in turn stimulates parietal cells to secrete
gastric acid. Gastric acid is about 0.5% hydrochloric acid (HCl), which
lowers the pH to the desired pH of 1-3. Acid release is also triggered by
acetylcholine and histamine. The intestinal phase has two parts, the
excitatory and the inhibitory. Partially digested food fills the duodenum. This
triggers intestinal gastrin to be released. Enterogastric reflex inhibits vagal
nuclei, activating sympathetic fibers causing the pyloric sphincter to tighten
to prevent more food from entering, and inhibits local reflexes.
Digestion begins in the mouth with the secretion of saliva and its digestive
enzymes. Food is formed into a bolus by the mechanical mastication and
swallowed into the esophagus from where it enters the stomach through the
action of peristalsis. Gastric juice contains hydrochloric acid and pepsin
which would damage the walls of the stomach and mucus is secreted for
protection. In the stomach further release of enzymes break down the food
further and this is combined with the churning action of the stomach. The
partially digested food enters the duodenum as a thick semi-liquid chyme. In
the small intestine, the larger part of digestion takes place and this is helped
by the secretions of bile, pancreatic juice and intestinal juice. The intestinal
walls are lined with villi, and their epithelial cells is covered with numerous
microvilli to improve the absorption of nutrients by increasing the surface
area of the intestine.
In the large intestine the passage of food is slower to enable fermentation by
the gut flora to take place. Here water is absorbed and waste material stored
as feces to be removed by defecation via the anal canal and anus.
Breakdown into nutrients
This section needs expansion with: digestion of other substances. You
can help by adding to it. (August 2011)
Protein digestion
Protein digestion occurs in the stomach and duodenum in which 3 main
enzymes, pepsin secreted by the stomach and trypsin and chymotrypsin
secreted by the pancreas, break down food proteins into polypeptides that are
then broken down by various exopeptidases and dipeptidases into amino
acids. The digestive enzymes however are mostly secreted as their inactive
precursors, the zymogens. For example, trypsin is secreted by pancreas in the
form of trypsinogen, which is activated in the duodenum by enterokinase to
form trypsin. Trypsin then cleaves proteins to smaller polypeptides.
Fat digestion
Main article: Fatty acid metabolism § Dietary sources of fatty acids, their
digestion, absorption, transport in the blood and storage
Digestion of some fats can begin in the mouth where lingual lipase breaks
down some short chain lipids into diglycerides. However fats are mainly
digested in the small intestine.[17] The presence of fat in the small intestine
produces hormones that stimulate the release of pancreatic lipase from the
pancreas and bile from the liver which helps in the emulsification of fats for
absorption of fatty acids.[17] Complete digestion of one molecule of fat (a
triglyceride) results a mixture of fatty acids, mono- and di-glycerides, as well
as some undigested triglycerides, but no free glycerol molecules.[17]
Carbohydrate digestion
In humans, dietary starches are composed of glucose units arranged in long
chains called amylose, a polysaccharide. During digestion, bonds between
glucose molecules are broken by salivary and pancreatic amylase, resulting
in progressively smaller chains of glucose. This results in simple sugars
glucose and maltose (2 glucose molecules) that can be absorbed by the small
intestine.
Lactase is an enzyme that breaks down the disaccharide lactose to its
component parts, glucose and galactose. Glucose and galactose can be
absorbed by the small intestine. Approximately 65 percent of the adult
population produce only small amounts of lactase and are unable to eat
unfermented milk-based foods. This is commonly known as lactose
intolerance. Lactose intolerance varies widely by ethnic heritage; more than
90 percent of peoples of east Asian descent are lactose intolerant, in contrast
to about 5 percent of people of northern European descent.[18]
Sucrase is an enzyme that breaks down the disaccharide sucrose, commonly
known as table sugar, cane sugar, or beet sugar. Sucrose digestion yields the
sugars fructose and glucose which are readily absorbed by the small
intestine.
DNA and RNA digestion
DNA and RNA are broken down into mononucleotides by the nucleases
deoxyribonuclease and ribonuclease (DNase and RNase) from the pancreas.
Non-destructive digestion
Some nutrients are complex molecules (for example vitamin B12) which
would be destroyed if they were broken down into their functional groups.
To digest vitamin B12 non-destructively, haptocorrin in saliva strongly binds
and protects the B12 molecules from stomach acid as they enter the stomach
and are cleaved from their protein complexes.[19]
After the B12-haptocorrin complexes pass from the stomach via the pylorus to
the duodenum, pancreatic proteases cleave haptocorrin from the B12
molecules which rebind to intrinsic factor (IF). These B12-IF complexes
travel to the ileum portion of the small intestine where cubilin receptors
enable assimilation and circulation of B12-IF complexes in the blood.[20]
Digestive hormones
Action of the major digestive hormones
There are at least five hormones that aid and regulate the digestive system in
mammals. There are variations across the vertebrates, as for instance in birds.
Arrangements are complex and additional details are regularly discovered.
For instance, more connections to metabolic control (largely the glucose-
insulin system) have been uncovered in recent years.
 Gastrin – is in the stomach and stimulates the gastric glands to
secrete pepsinogen (an inactive form of the enzyme pepsin) and
hydrochloric acid. Secretion of gastrin is stimulated by food arriving
in stomach. The secretion is inhibited by low pH.
 Secretin – is in the duodenum and signals the secretion of sodium
bicarbonate in the pancreas and it stimulates the bile secretion in the
liver. This hormone responds to the acidity of the chyme.
 Cholecystokinin (CCK) – is in the duodenum and stimulates the
release of digestive enzymes in the pancreas and stimulates the
emptying of bile in the gall bladder. This hormone is secreted in
response to fat in chyme.
 Gastric inhibitory peptide (GIP) – is in the duodenum and decreases
the stomach churning in turn slowing the emptying in the stomach.
Another function is to induce insulin secretion.
 Motilin – is in the duodenum and increases the migrating
myoelectric complex component of gastrointestinal motility and
stimulates the production of pepsin.