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OBJECTIVES

OBJECTIVES

After studying this chapter, you should be able to:

  • Understand the functional significance of the gastrointestinal system, and in particular, its roles in nutrient assimilation, excretion, and immunity.

  • Describe the structure of the gastrointestinal tract, the glands that drain into it, and its subdivision into functional segments.

  • List the major gastrointestinal secretions, their components, and the stimuli that regulate their production.

  • Describe water balance in the gastrointestinal tract and explain how the level of luminal fluidity is adjusted.

  • Identify the major hormones, other peptides, and key neurotransmitters of the gastrointestinal system.

  • Describe the special features of the enteric nervous system and the splanchnic circulation.

INTRODUCTION

The primary function of the gastrointestinal tract is to serve as a portal whereby nutrients and water can be absorbed into the body. In fulfilling this function, the meal is mixed with a variety of secretions from the gastrointestinal tract itself and organs that drain into it, such as the pancreas, gallbladder, and salivary glands. Likewise, the intestine displays motility patterns that mix the meal with digestive secretions and move it along the length of the gastrointestinal tract. Ultimately, residues of the meal that cannot be absorbed, along with cellular debris, are expelled from the body. All of these functions are tightly regulated via mechanisms that act both locally and over long distances to coordinate the function of the gut and the organs that drain into it.

STRUCTURAL CONSIDERATIONS

The parts of the gastrointestinal tract that are encountered by the meal or its residues include, in order, the mouth, esophagus, stomach, duodenum, jejunum, ileum, cecum, colon, rectum, and anus. Throughout the length of the intestine, glandular structures deliver secretions into the lumen. Also important in the process of digestion are secretions from the pancreas and the biliary system of the liver. The intestine has a very substantial surface area, which is important for its absorptive function. The intestinal tract is functionally divided into segments by means of muscle rings known as sphincters, which restrict the flow of intestinal contents to optimize digestion and absorption. These sphincters include the upper and lower esophageal sphincters, the pylorus that retards emptying of the stomach, the ileocecal valve that retains colonic contents in the large intestine, and the inner and outer anal sphincters.

The intestine is composed of functional layers. Immediately adjacent to nutrients in the lumen is a single layer of columnar epithelial cells. Below the epithelium is a layer of loose connective tissue known as the lamina propria, which in turn is surrounded by circular and longitudinal muscle layers. The intestine is also amply supplied with blood vessels, nerve endings, and lymphatics.

The epithelium of the intestine is also further specialized in a way that maximizes its surface area. Throughout the small intestine, it is folded into fingerlike projections called villi. Between the villi are infoldings known as ...

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